Abstract: SA-PO145

Effect of Statin Therapy on Markers of Thrombosis and Inflammation in ESRD

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Chang, Daniel, New York Presbyterian / Queens, Fresh Meadows, New York, United States
  • Moreno Castaneda, Carlos H., New York Presbyterian / Queens, Fresh Meadows, New York, United States
  • Yousaf, Farhanah, New York Presbyterian / Queens, Fresh Meadows, New York, United States
  • Hussain, Hafiz, New York Presbyterian / Queens, Fresh Meadows, New York, United States
  • Charytan, Chaim, New York Presbyterian / Queens, Fresh Meadows, New York, United States
  • Spinowitz, Bruce S., New York Hospital Medical Center of Queens, New Rochelle, New York, United States
Background

Large platelets have more granules, aggregate more rapidly with collagen, have higher thromboxane A2 levels and express more glycoprotein Ib and IIb/IIIa receptors. Upper quintile limit of mean platelet volume (MPV) predicts coronary artery disease in the hemodialysis population. Evidence suggests that statins may reduce MPV.

Methods

Medical records of prevalent hemodialysis patients as of 30Jun2016 were reviewed. Statins group included patients taking statins ≥6 months prior to 1Jan2016 and continued statins until 30Jun2016. No statins group included patients never taking statins or who stopped taking statins >6 months prior to 1Jan2016. Basic demographic, comorbidity, and laboratory data was tabulated. Independent t-test was used to compare 6-month (1Jan–30Jun2016) average MPV, WBC to MPV ratio, and ferritin levels in no statins versus statins groups.

Results

224 patients were prevalent as of 30Jun2016. Exclusion consisted of 20 new patients, 98 with active infection or hospitalization, 5 on omega-3, 6 on steroid, 9 on statins <6 months, 7 started statins after 31Dec2015, 3 stopped statins between 1Jan-30Jun2016, and 5 received blood transfusion. In remaining 71 patients, 36 patients (24 males, 11 diabetics) aged 61±17 years never used or discontinued statins >6 months prior to 1Jan2016 while 35 patients (22 males, 22 diabetics) aged 70±13 years (p=0.018) taking statins ≥6 months prior to 1Jan2016 and continued statins until 30Jun2016. In statins group, 2 were on low intensity,26 were on moderate intensity,and 7 were on high intensity statins. No statins group had higher mean cholesterol (159±34 vs 134±40 mg/dL) and LDL level (94±28 vs 73±34mg/dL) compared to statins group. After controlling for age and diabetes (r2=0.2), mean MPV was significantly higher in statins group (11.2±1fL) versus no statins group (10.4±1fL) [p=0.013] while WBC to MPV ratio and ferritin levels were similar.

Conclusion

Our findings suggest that statin therapy in hemodialysis population is not associated with lower but rather higher MPV. Moreover, WBC to MPV ratio and ferritin levels are unaffected by the use of statins. Lack of statins impact on markers of thrombosis and inflammation in end stage renal disease may explain lack of mortality benefit observed in previous literature.