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2016 ; 1
(4
): 279-287
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Statin Use and Survival After Acute Kidney Injury
#MMPMID29142930
Brar S
; Ye F
; James M
; Hemmelgarn B
; Klarenbach S
; Pannu N
Kidney Int Rep
2016[Nov]; 1
(4
): 279-287
PMID29142930
show ga
INTRODUCTION: The incidence of acute kidney injury (AKI) in hospitalized patients
is rising, and survivors are at high risk for cardiovascular events and
mortality. Effective strategies that improve long-term outcomes of AKI are
unknown. METHODS: A retrospective cohort study was performed between 2008 and
2011. All subjects were followed until 31 March 2013, with a minimum follow-up of
2 years. Participants were adults 18 years of age or older, who developed AKI
during a hospitalization and had chronic kidney disease (CKD) following discharge
(n = 19,707 mean age 69.9 years, mean postdischarge estimated glomerular
filtration rate (eGFR) 43.0 ml/min/1.73 m(2)). Exposure to statins was examined
prior to the index hospitalization as well as within 2 years following hospital
discharge. The primary outcome was mortality; secondary outcomes included
all-cause re-hospitalization and cardiovascular events. RESULTS: Within 2 years
of discharge, only 38.3% of the participants were prescribed a statin. After
adjustment for comorbidities, statin use prior to admission, demographics,
baseline kidney function, and a number of other factors, statin use was
associated with lower mortality (hazard ratio, 0.74; 95% confidence interval,
0.69, 0.79) in AKI survivors with CKD. Patients who received a statin also had a
lower risk of all cause rehospitalization (adjusted hazarad ratio, 0.90; 95%
confidence interval, 0.85, 0.94). Statin use was not associated with a reduction
in cardiovascular events. DISCUSSION: Among AKI survivors with CKD, statin use
was associated with a lower risk of mortality and rehospitalization rates. This
finding suggests that there is an opportunity to improve postdischarge care in
AKI survivors.