Kidney Week

Abstract: FR-PO900

Association of Niacin Use With Kidney Outcomes

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Whitecavage, Shaun M., University of California Irvine Medical Center, Orange, California, United States

Shaun M. Whitecavage,

• Tran, Diana, University of California Irvine Medical Center, Orange, California, United States

Diana Tran,

• Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Keiichi Sumida,

• Thomas, Fridtjof, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Fridtjof Thomas,

• Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Kalantar-Zadeh, Kamyar, University of California Irvine Medical Center, Orange, California, United States

Kamyar Kalantar-Zadeh,

• Streja, Elani, University of California Irvine Medical Center, Orange, California, United States

Elani Streja,

Background

Niacin is a non-statin lipid lowering therapy that has been shown to lower triglycerides and to improve other risk factors for renal outcomes. Despite these favorable data, the effect of niacin on long term kidney outcomes remains unclear.

Methods

In a nationwide historic cohort of 1,139,630 US Veterans with normal baseline eGFR, we examined the association of de novo prescription of niacin during 2005-2006 with ESKD, incident CKD (defined as eGFR <60 ml/min/1.73m² on two occasions, separated by ≥90 days) and death. Associations were examined in Cox hazard models adjusted for demographics, major comorbidities, and lab measurements. Prescription time-distribution matching was used to control for survival bias.

Results

We identified 133,450 new users of niacin. Overall, patients were a mean (SD) 60 (13) years old, with 6% female, 16% Black, and 6% Hispanic. Niacin users were more likely to be male, White, current, or former smokers, with higher frequencies of comorbidities. Niacin was associated with lower risk of death (HR: 0.81, 95% CI: 0.80-0.82) and ESKD (0.85, 0.79-0.92), but with a higher risk of CKD (1.16, 1.15-1.17). The rates at which niacin users experienced death was slower compared to non-users (2.907 versus 3.649). However, the rates at which niacin users experienced ESKD and incident CKD were faster compared to non-users (0.066 versus 0.081 and 3.967 versus 3.018) respectively.

Conclusion

Niacin use was associated with a lower risk of ESKD and death, but with higher risk of incident CKD (potentially explained by acute effects on eGFR) in this large national cohort of patients with normal kidney function. Further studies are needed to corroborate the potential benefits of niacin on kidney function and survival.

Event Rates and Hazard Ratios for Death, ESKD, and CKD Among Niacin Users vs. Non-Users

Funding

• NIDDK Support