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Statin Use and the Risk of Kidney Disease With Long-Term Follow-Up (8.4-Year Study)

  • Tushar Acharya
    Affiliations
    Division of Cardiology, Department of Internal Medicine, University of California, San Francisco–Fresno Medical Education Program, Fresno, California
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  • Jian Huang
    Affiliations
    Medicine Service, VA Central California Health Care System, Fresno, California

    Department of Medicine, University of California, San Francisco–Fresno Medical Education Program, Fresno, California
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  • Steven Tringali
    Affiliations
    Department of Medicine, University of California, San Francisco–Fresno Medical Education Program, Fresno, California
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  • Christopher R. Frei
    Affiliations
    Division of Pharmacotherapy, College of Pharmacy, The University of Texas at Austin, Austin, Texas

    Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio, Texas
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  • Eric M. Mortensen
    Affiliations
    Department of Medicine, VA North Texas Health Care System, Dallas, Texas

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas

    Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
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  • Ishak A. Mansi
    Correspondence
    Corresponding author: Tel/fax: (214) 857-1505.
    Affiliations
    Department of Medicine, VA North Texas Health Care System, Dallas, Texas

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas

    Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
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Published:December 01, 2015DOI:https://doi.org/10.1016/j.amjcard.2015.11.031
      Few studies have examined long-term effects of statin therapy on kidney diseases. The objective of this study was to determine the association of statin use with incidence of acute and chronic kidney diseases after prolonged follow-up. In this retrospective cohort study, we analyzed data from the San Antonio area military health care system from October 2003 through March 2012. Statin users were propensity score matched to nonusers using 82 baseline characteristics including demographics, co-morbidities, medications, and health care utilization. Study outcomes were acute kidney injury, chronic kidney disease (CKD), and nephritis/nephrosis/renal sclerosis. Of the 43,438 subjects included, we propensity score matched 6,342 statin users with 6,342 nonusers. Statin users had greater odds of acute kidney injury (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.14 to 1.48), CKD (OR 1.36, 95% CI 1.22 to 1.52), and nephritis/nephrosis/renal sclerosis (OR 1.35, 95% CI 1.05 to 1.73). In a subset of patients without co-morbidities, the association of statin use with CKD remained significant (OR 1.53, 95% CI 1.27 to 1.85). In a secondary analysis, adjusting for diseases/conditions that developed during follow-up weakened this association. In conclusion, statin use is associated with increased incidence of acute and chronic kidney disease. These findings are cautionary and suggest that long-term effects of statins in real-life patients may differ from shorter term effects in selected clinical trial populations.
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