Abstract: FR-PO441

The Effect of Statin Therapy on Clinical Outcomes in Patients with CKD: The Results from the KNOW-CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • An, Seong yeong, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Nam, Ki Heon, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Jhee, Jong Hyun, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Park, Seohyun, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Han, Seung Hyeok, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Han, Dae-Suk, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
Background

Statin therapy is a main part of the management of lipid disorders in patients with CKD. However, the effects of statin use against CKD progression and cardiovascular events are still under debate in these patients. Also, it is unknown whether clinical outcomes are affected by lipophilic or hydrophilic nature of statins.

Methods

We studied the effects of use and types of statins on clinical outcomes in 2,238 patients using the database from the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD). Statin users were defined if they were treated with statins at baseline. And, statin users were further classified into lipophilic or hydrophilic statin users depending on types of statins. Primary outcome was a composite of a 50% decline in eGFR, ESRD, cardiovascular events, and death.

Results

During a mean follow-up duration of 38 months, the composite outcome occurred in 74 (9.3%) patients among statin users as compared to 55 (7.1%) among non-users (P=0.119). In a multivariable Cox model after adjustment of confounding factors, statin use was not associated with a decreased risk of primary outcome (HR, 0.85; 95% CI, 0.67-1.07; P=0.168). However, in a subgroup of patients with eGFR of ≥ 30 ml/min/1.73 m2, statin users were significantly associated with a 39% reduction in primary outcome as compare to non-users (HR, 0.61; 95% CI, 0.39-0.95; P=0.030). In addition, hydrophilic statin users had a lower risk of developing the endpoint than non-users in this subgroup (HR, 0.57; 95% CI, 0.34-0.97; P=0.037), whereas lipophilic statin users did not have such benefit (HR, 0.65; 95% CI, 0.38-1.09; P=0.104). However, there was no difference in HRs for primary outcome between hydrophilic and lipophilic statin users.

Conclusion

Statin use was associated with improved outcomes in early stages of CKD and the effectiveness was similar between hydrophilic and lipophilic statin users.