Effect of statins on survival in patients undergoing dialysis access for end-stage renal disease

Rango, Paola De; Parente, Basso; Farchioni, Luca; Cieri, Enrico; Fiorucci, Beatrice; Pelliccia, Selena; Manzone, Alessandra; Simonte, Gioele; Lenti, Massimo

doi:10.1053/j.semvascsurg.2017.03.001

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…Similar results were reported from the Dialysis Outcomes and Practice Patterns Study 36 and in the Taiwan National Health Insurance Research Database study. 37 Other studies have found similar associations for specific dialysis populations, including those who sustained a myocardial infarction, 38 , 39 , 40 those who underwent vascular access placement surgery, 41 and those who had diabetes. 42 , 43 In addition, a meta-analysis 44 that included both RCTs and cohort studies showed that the effect of statin use in patients with diabetes receiving dialysis was associated with a lower risk of all combined cardiac events and all-cause mortality.…”

Section: Discussionmentioning

confidence: 75%

Association of Continuation of Statin Therapy Initiated Before Transition to Chronic Dialysis Therapy With Mortality After Dialysis Initiation

et al. 2018

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Key Points Question Is the use of statins initiated during late-stage chronic kidney disease and continued after transition to dialysis associated with an improvement in subsequent survival? Findings In this cohort study of 14 298 US veterans transitioning to dialysis, the continuation of statin therapy was associated with a 28% and 18% lower risk of 12-month all-cause mortality and cardiovascular mortality, respectively, compared with the discontinuation of statin therapy. Meaning The continuation of statin therapy after transition to dialysis was associated with reduced all-cause mortality and cardiovascular mortality in veterans.

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Section: Discussionmentioning

confidence: 75%

Association of Continuation of Statin Therapy Initiated Before Transition to Chronic Dialysis Therapy With Mortality After Dialysis Initiation

et al. 2018

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“…This simulated observational trial may help in providing evidence to develop potential studies on treatment effectiveness. Several recent studies using real-world data have also reported the ST benefit in the associations with reduced ACM for patients undergoing HD (De Rango et al, 2016;Chung et al, 2017;Kim et al, 2018;Jung et al, 2020). An Italian study comparing the ACM risk between HD patients with ST (n = 127) and without ST (n = 232) found that ST reduced the risk for nearly 50%, 5 years after a vascular access operation (De Rango et al, 2016).…”

Section: Resultsmentioning

confidence: 97%

“…For diabetic dialysis patients with pretreatment LDL-cholesterol >145 mg/dl in the 4D trial, März et al reported that atorvastatin treatment could reduce 28%-52% of the risk for composite cardiovascular outcomes, cardiac deaths, and all-cause deaths (März et al, 2011). Recent studies using real-world data showed that ST could reduce the ACM for dialysis patients, particularly for HD patients (De Rango et al, 2016;Chung et al, 2017;Kim et al, 2018;Ota et al, 2019). A recent Korean population-based study found that ST was associated with reduced ACM for over 41% in HD patients (Jung et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Statin Therapy for Hyperlipidemic Patients With Chronic Kidney Disease and End-Stage Renal Disease: A Retrospective Cohort Study Based on 925,418 Adults in Taiwan

et al. 2022

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Background: For non-dialysis patients with hyperlipidemia, statins may provide clinical benefits in reducing mortality risk; however, the optimal treatment for dialysis patients with hyperlipidemia remains debatable. We evaluated the mortality risks for hyperlipidemic patients with renal disorders associated with statin therapy (ST), using the insurance claims data of Taiwan.Methods: From hyperlipidemic patients diagnosed in 2000–2011, we identified 555,153 patients receiving statin treatment for at least 90 days continuously and 1,141,901 non-statin users, and then randomly selected, from both groups, the propensity score-matched subcohorts of statin users and nonusers in a 1:1 pair by renal function: 415,453 pairs with normal renal function , 43,632 pairs with chronic kidney disease (CKD), and 3,624 pairs with end-stage renal disease (ESRD). We compared the mortalities, by the end of 2016, from all causes, cancer, heart disease, and septicemia between statin users and non-users and between hydrophilic-statin users and lipophilic-statin users. The Cox method estimated ST users to non-user hazard ratios. The time-dependent model was also conducted as sensitivity analysis.Results: The mean ages were 58.7 ± 10.7, 64.2 ± 10.7, and 62.2 ± 10.8 years in normal renal function, CKD, and ESRD groups, respectively. Compared with non-users, statin users had reduced mortality risks from all causes for 32%–38%, from cancer for 37%–46%, from heart disease for 6%–24%, and from septicemia for 17%–21% in all three renal groups. The hydrophilic statin therapy was superior than the lipophilic statin therapy, particularly for reducing deaths from all-causes and cancer. The results under the time-dependent model were similar.Conclusion: Statin therapy is associated with reduced all-causes and non-cardiovascular mortality in ESRD patients.

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“…However, some studies have suggested a beneficial role of statins in renal disease [38][39][40][41], and perhaps this contributes to improved outcomes for renal transplant recipients in the setting of sepsis. De Rango et al [42] reported that statin use might reduce the all-cause mortality in adult patients with chronic kidney disease and vascular access for chronic dialysis by 50% at 5 years post-transplant, and Sanada et al [43] found that statin treatment prolonged hemodialysis vascular access survival. Additionally, Zahr et al [44] treated humanized sickle cell mice with atorvastatin and found that this significantly reduced albuminuria and improved urine concentrating ability and glomerular filtration rate.…”

Section: Discussionmentioning

confidence: 99%

“…Other investigators have explored the use of metformin in renal and infectious diseases [42,44,45]. Rafieian-Kopaie [46] reported that metformin has a protective effect against renal tubular injury by tempering oxidative stress on the renal tubules.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for complications and graft failure in kidney transplant patients with sepsis

Syu

Lin

et al. 2018

Bosn J of Basic Med Sci

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Immunosuppressive therapies decreased the incidence of acute kidney rejection after kidney transplantation, but also increased the risk of infections and sepsis. This study aimed to identify the risk factors associated with complications and/or graft failure in kidney transplant patients with sepsis. A total of 14,658 kidney transplant patients with sepsis, identified in the National Inpatient Sample (NIS) database (data from 2005–2014), were included in the study and classified into three groups: patients without complications or graft failure/dialysis (Group 1), patients with complications only (Group 2), and patients with complications and graft failure/dialysis (Group 3). Multinomial logistic regression analyses were conducted to evaluate factors associated with kidney transplant recipients. Multivariate analysis showed that, compared to Group 1, patients from Group 2 or Group 3 were more likely to be Black and to have cytomegalovirus infection, coagulopathy, and glomerulonephritis (p ≤ 0.041). Also, Group 2 was more likely to have herpes simplex virus infection, and Group 3 was more likely to have hepatitis C infection and peripheral vascular disorders, compared to Group 1 (p ≤ 0.002). In addition, patients from Group 3 were more likely to be Black and to have hepatitis C infection, peripheral vascular disorders, coagulopathy, and hypertension compared to Group 2 (p ≤ 0.039). Age and female gender were associated with lower odds of complications after kidney transplantation regardless of graft rejection/dialysis (p ≤ 0.049). Hyperlipidemia and diabetes decreased the chance of complications and graft failure/dialysis after kidney transplant (p < 0.001). In conclusion, the study highlights that black race, male gender, and specific comorbidities can increase the risk of complications and graft failure in kidney transplant patients with sepsis.

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Effect of statins on survival in patients undergoing dialysis access for end-stage renal disease

Cited by 6 publications

References 26 publications

Association of Continuation of Statin Therapy Initiated Before Transition to Chronic Dialysis Therapy With Mortality After Dialysis Initiation

Association of Continuation of Statin Therapy Initiated Before Transition to Chronic Dialysis Therapy With Mortality After Dialysis Initiation

Statin Therapy for Hyperlipidemic Patients With Chronic Kidney Disease and End-Stage Renal Disease: A Retrospective Cohort Study Based on 925,418 Adults in Taiwan

Risk factors for complications and graft failure in kidney transplant patients with sepsis

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