Abstract: FR-PO413
Statin Dose Prior to Dialysis Transition with Post-Transition Hospitalization Frequency
Session Information
- Hemodialysis and Frequent Dialysis - III
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Park, Christina, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Hsiung, Jui-Ting, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Soohoo, Melissa, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Marroquin, Maria V., Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Moradi, Hamid, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Rhee, Connie, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
- Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Orange, California, United States
Background
In a prior study, we demonstrated that statin use prior to dialysis start was associated with lower mortality and hospitalization risk. Although current guidelines advocate for initiation of a moderate dose statin in late stage chronic kidney disease (CKD), we sought to examine whether risk of hospitalization, in particular septicemia, in the year after dialysis start differed according to statin dose in the year prior to transition.
Methods
In a cohort of veterans transitioning to dialysis from 2007-2015, we identified 32,439 patients on low-, moderate- and high-dose statin therapy for at least 181 days in the year prior to dialysis start. Poisson models with adjustment for demographics, comorbidities and use of other lipid altering medications were used to examine associations between statin dose of hospitalization incidence.
Results
Cohort mean±SD age was 72±10 years old, 4% were female, 21% African American, 6% Hispanic, 80% diabetic and 39% had a prior myocardial infarction. High-dose patients were more likely to be younger, African American and diabetic but less likely to have liver disease or cancer. In unadjusted and adjusted analyses, statin dose had a linear association with hospitalization rates. Compared with moderate statin dose (reference), low- and high-dose statin therapy were associated with higher and lower hospitalization rates, respectively [IRRs (95% CIs) 1.03 (1.01, 1.06) and 0.95 (0.93, 0.97), respectively]. Associations were similar for septicemia hospitalizations.
Conclusion
Risk of hospitalization, particularly septicemia, in the year after transition to dialysis was lower with higher statin dose therapy. Statins are known to have anti-inflammatory benefits and further studies are needed to investigate whether the use of higher dose statins confers benefits that outweigh risk of adverse events in patients transitioning to dialysis.
Funding
- NIDDK Support