Short-term rosuvastatin therapy prevents contrast-induced acute kidney injury in female patients with diabetes and chronic kidney disease: a subgroup analysis of the TRACK-D study

Abstract

Background: Female patients are at higher risk of contrast-induced acute kidney injury (CIAKI) compared to males. In the multicenter, prospective, TRACK-D study, short-term rosuvastatin has proven effectively reduce CIAKI in patients with type 2 diabetes mellitus and stage 2-3 chronic kidney disease (CKD). This study aimed to explore the efficacy of rosuvastatin in the female TRACK-D population.Methods: This study was a gender-based analysis of 2,998 patients (1,044 females) enrolled in the TRACK-D study and were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard of care. The primary outcome was the incidence of CIAKI and the secondary outcome was a composite of death, dialysis/hemofiltration or worsening heart failure at 30 days.Results: CIAKI incidence was comparable between male and female patients in the overall study population (2.5% vs. 3.4%, P=0.165) and in the rosuvastatin group (2.4% vs. 2.1%, P=0.72), while it was higher in females than in males in the control group (3.1% vs. 5.3%, P=0.04). Female gender was an independent risk factor of CIAKI [odds ratio (OR) =1.65; 95% confidence interval (CI), 1.03-2.63; P=0.036].Rosuvastatin treatment vs. control lowered CIAKI rate in females [2.1% vs. 5.3%; relative risk (RR) =0.39; 95% CI, 0.19-0.77; number needed to treat (NNT) =31], particularly among those with CKD stage 2 (1.2% vs. 4.1%, P=0.011). Secondary outcome incidence was similar for females in the rosuvastatin and control groups (3.7% vs. 4.9%, P=0.37). Conclusions: Compared to males, untreated females with diabetes mellitus and CKD had a higher risk of CIAKI, which can be reduced by short-term rosuvastatin treatment.

Protective Effects and Mechanisms of Rosuvastatin on Acute Kidney Injury Induced by Contrast Media in Rats

“…Studies have suggested that there is a negative correlation between SOD content and kidney damage [18]. Statins are known to be pleiotropic, including antioxidant properties, and they can prevent renal ischemia by stabilizing renal vascular endothelial cells and eliminating oxygen-free radicals, thereby preventing the occurrence of CIN [19]. is study revealed that SOD activity in rat kidney tissues decreased significantly over the time after injection of contrast media, indicating that oxidative stress is involved in the occurrence of contrast agent renal injury.…”

Association Between the Lipid Profile and Renal Dysfunction in the Heart Failure Patients

“…It is easy to understand that the improve of heart function (LVEF) [44] and nutrition status (albumin) [45] may lead to better kidney perfusion and less kidney damage, which could result in better renal function. Meanwhile, female sex [46] and hypertension [47] were traditional risk factors responsible for the deterioration of renal function. Interestingly, MPV was found to be a risk factor for renal function with OR=1.992 ( P =0.005).…”

Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017

“…An RCT in 410 CKD patients showed less CA-AKI in patients randomised to a single dose of atorvastatin within 24 h before contrast exposure compared to the control group (4.5% vs. 17.8%, p  = 0.005) [257]. Two more recent RCTs found similar effects of statins in diabetics with CKD [258, 259]. These positive findings were confirmed by several meta-analyses combining studies in patients undergoing coronary angiography [260–263] (ESM_2 Table S14).…”