Kidney Research and Clinical Practice 2020 Mar; 39(1): 93-102  
Intensity of statin therapy and renal outcome in chronic kidney disease: Results from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease
Jong Hyun Jhee1 , Young Su Joo2 , Jung Tak Park3 , Tae-Hyun Yoo3 , Sue Kyung Park4 , Ji Yong Jung5 , Soo Wan Kim6 , Yun Kyu Oh7 , Kook-Hwan Oh8 , Shin-Wook Kang3,9 , Kyu Hun Choi3 , Curie Ahn8 , Seung Hyeok Han3
1Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
2Division of Nephrology, Department of Internal Medicine, Myongji Hospital, Goyang, Republic of Korea
3Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
4Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
5Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
6Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
7Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
8Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
9Department of Internal Medicine, College of Medicine, Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea
Correspondence to: Seung Hyeok Han
Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. E-mail: hansh@yuhs.ac

Edited by Dong-Ryeol Ryu, Ewha Womans University, Seoul, Republic of Korea
Received: January 14, 2020; Revised: February 13, 2020; Accepted: February 13, 2020; Published online: March 31, 2020.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Higher statin intensity is associated with a lower risk of mortality in patients with cardiovascular disease. However, little is known about the relationship between statin intensity and chronic kidney disease (CKD) progression.
Methods: We studied whether statin intensity affects kidney function decline in 1,073 patients from the Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease. The participants were classified based on statin intensity as low, moderate, and high. The study endpoint was CKD progression (composite of doubling of serum creatinine, ≥ 50% decrease in estimated glomerular filtration rate [eGFR] from baseline, or end-stage renal disease).
Results: The mean age was 56.0 ± 11.4 years, and 665 (62.0%) participants were male. The mean eGFR was 51.7 ± 26.7 mL/min/1.73 m2; there were no differences in baseline eGFR among statin intensity groups. During the median follow-up of 39.9 (25.4-61.6) months, 255 (23.8%) patients reached the study endpoint. In multivariable Cox model after adjustment of confounders, the hazard ratios (95% confidence interval) for adverse kidney outcome were 0.97 (0.72-1.30) and 1.15 (0.60-2.20) in moderate and high statin intensity groups, respectively, compared with the low intensity group. In addition, no significant association was observed in subgroups stratified by age, sex, eGFR, and atherosclerotic cardiovascular disease risk scores.
Conclusion: We did not observe any significant association between intensity of statin therapy and progression of CKD. Long-term kidney outcomes may not be affected by statin intensity.
Keywords: Chronic kidney disease, Disease progression, Intensity, Statin


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Funding Information
  • Korea Centers for Disease Control and Prevention
      10.13039/501100003669
      2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, and 2016E3300200

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