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Abstract: TH-PO1047

Trends in Statin Use Among Those with CKD in the United States, 1999 to 2014

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Murphy, Daniel P., University of Minnesota, Minneapolis, Minnesota, United States
  • Foley, Robert N., University of Minnesota, Minneapolis, Minnesota, United States
Background

Chronic kidney disease (CKD) has been recognized as a risk factor for cardiovascular disease (CVD). Statins have been shown to reduce CVD events in those with CKD not on dialysis, and CKD has been suggested as a candidate for determining statin therapy in cholesterol-focused guidelines. Statins have been shown to be used by a minority of those with CKD. Descriptions of temporal tends and disparities in statin use among those with CKD, identifying those who may benefit most from inclusion of CKD in such guidelines, are needed.

Methods

We studied trends in statin use among adult participants of the National Health and Nutrition Examination Survey, years 1999-2014, with creatinine-based estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or albumin-creatinine ratio ≥ 30 mg/g. Differences among racial/ethnic, other demographic, and comorbid characteristics were also examined.

Results

28.9% of those with CKD used a statin. Encouragingly, statin use rose across the four eras studied (P < 0.001), though they may have begun to plateau after 2010: 1999-2002, 17.1%; 2003-2006, 27.0%; 2007-2010, 33.4%, and 2011-2014, 35.6%. While albuminuria increased the likelihood of statin use (23.6% vs 12.2%, P < 0.001), a greater effect was seen among those with reduced eGFR < 60 ml/min/1.73m2 compared to those with preserved eGFR (41.4% vs 11.4%, P < 0.001). Those of Hispanic race/ethnicity with CKD received fewer statins: 15.4% compared to 32.0% for white, 26.2% for black, and 24.6% for other race/ethnicity (P < 0.001). Statin use was more prevalent among males with CKD than females (32.4% vs. 26.3%, P < 0.001). In age, sex, and race/ethnicity adjusted models, statins were associated with: era (adjusted odds ratio (AOR) 1.77 [95% CI: 1.44-2.17] for 2003-2006, 2.51 [95% CI: 2.04-3.08] for 2007-2010, and 2.94 [95% CI: 2.34-3.70] for 2011-2014, vs. 1999-2002) and Hispanic race/ethnicity (AOR 0.62 [95% CI: 0.50-0.78] vs. white). Other multivariate associations (P < 0.05) were older age, male sex, BMI ≥ 30 kg/m2, diabetes mellitus, hypertension, myocardial infarction, heart failure, and stroke.

Conclusion

Statin use has increased over time but remains the case for the minority in community-based CKD. Those of Hispanic race/ethnicity with CKD receive the fewest statins while males with CKD receive statins more often than females. Further research into such disparities is needed.