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Kidney Week

Abstract: FR-PO050

The Relationship Between Statin Use and 1-Year Mortality After Severe AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Wu, Chia-Lin, Changhua Christian Hospital, Changhua, Taiwan
  • Hsu, Chih-cheng, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
  • Tarng, Der-Cherng, Taipei Veteran's General Hospital, Taipei, Taiwan
Background

The potential survival benefits of statin use in patients with dialysis-requiring acute kidney injury (AKI) are still not known. We examined the association between statin use and 1-year mortality in patients with dialysis-requiring AKI.

Methods

This nationwide population-based retrospective cohort study included 6091 hospitalized patients with dialysis-requiring AKI (1271 statin users and 4820 statin non-users) retrieved from the National Health Insurance Research Database of Taiwan between January 1, 2000, and December 31, 2012. All patients were followed up until December 31, 2013. Primary outcome was 1-year mortality after dialysis-requiring AKI. All primary analyses were performed using the intention-to-treat approach.

Results

During the 1-year follow-up period, 492 of 1271 (38.7%) statin users and 2365 of 4820 (49.1%) statin non-users died after dialysis-requiring AKI. Statin use was independently associated with lower risks of 1-year all-cause mortality (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.73-0.91; p<0.001) and in-hospital all-cause mortality (HR, 0.82; 95% CI, 0.72-0.94; p=0.004). The survival benefit of statin treatment was dose-dependent and consistent across subgroups based on sensitivity analyses.

Conclusion

Statin use was independently associated with reduced risks of 1-year and in-hospital mortality in patients with dialysis-requiring AKI. However, further clinical trials are warranted to confirm our results.

Incidence and risk of 1-year mortality in patients with dialysis-requiring AKI
CohortsEvents (n/N)Incident rateCrude HR (95% CI)P valueAdjusted HR (95% CI)P value
Statin non-users2365/482068.7 (65.9–71.5)1 [Reference] 1 [Reference] 
Statin users492/127146.6 (42.4–50.7)0.71 (0.65–0.79)<0.0010.81 (0.73–0.91)<0.001
Stratified by cDDD      
cDDD <39266/65150.3 (44.3–56.4)0.77 (0.67–0.87)<0.0010.87 (0.76–0.99)0.04
cDDD >=39226/62042.8 (37.2–48.3)0.66 (0.58–0.76)<0.0010.75 (0.65–0.87)<0.001
P for trend   <0.001 <0.001

Incident rate: 1000 person-years

Kaplan-Meier curves for the cumulative incidences of all-cause mortality in statin users and non-users. cDDD = cumulative defined daily dose.