Abstract: FR-PO050
The Relationship Between Statin Use and 1-Year Mortality After Severe AKI
Session Information
- AKI: Clinical, Outcomes, Trials - I
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
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
| Cohorts | Events (n/N) | Incident rate | Crude HR (95% CI) | P value | Adjusted HR (95% CI) | P value |
| Statin non-users | 2365/4820 | 68.7 (65.9–71.5) | 1 [Reference] | 1 [Reference] | ||
| Statin users | 492/1271 | 46.6 (42.4–50.7) | 0.71 (0.65–0.79) | <0.001 | 0.81 (0.73–0.91) | <0.001 |
| Stratified by cDDD | ||||||
| cDDD <39 | 266/651 | 50.3 (44.3–56.4) | 0.77 (0.67–0.87) | <0.001 | 0.87 (0.76–0.99) | 0.04 |
| cDDD >=39 | 226/620 | 42.8 (37.2–48.3) | 0.66 (0.58–0.76) | <0.001 | 0.75 (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.