Statin initiation and all-cause mortality in incident statin-naive dialysis patients
- Kim, Ji Eun; Park, Sehoon; Kim, Myeong-Seok; Kang, Sung Jin; Lee, Jang Wook; Kim, Kwang Soo; Kim, Yong Chul; Kim, Dong Ki; Joo, Kwon Wook; Kim, Yon Su; Park, Minsu; Lee, Hajeong
- Issue Date
- ELSEVIER IRELAND LTD
- Statin; End-stage kidney disease; Mortality; Dialysis
- Atherosclerosis, v.337, pp.59 - 65
- Journal Title
- Start Page
- End Page
- Background and aims
Cardiovascular disease is the main cause of death in end-stage kidney disease (ESKD) patients. We aimed to explore the association between statin initiation after starting dialysis and all-cause mortality in statin-naïve ESKD patients.
We analyzed nationwide claims data of incident dialysis patients from 2010 to 2017 in South Korea. Patients who had previous cardiovascular events or were administered statins before dialysis were excluded. The study group included dialysis patients receiving statins within 1 year after dialysis initiation. The control group was organized after propensity-score matching with age, sex, time of dialysis initiation, and underlying diabetes mellitus and hypertension. The main outcomes were all-cause mortality and major cardiovascular events.
We included 1596 patients who started statin treatment and 1:1 matched statin-nonusers. During the 9438 person-year follow-up, 468 deaths and 264 major adverse cardiovascular events (MACEs) occurred. Statin initiation was associated with a reduced risk of all-cause mortality (adjusted hazard ratio (aHR) 0.72, 95% confidence interval (CI) 0.60–0.87, p = 0.001), but not with MACE incidence (aHR 1.06, 95% CI 0.83–1.36, p = 0.62). In particular, patients prescribed the recommended dosage of statins according to the Kidney Disease Improving Global Outcomes guidelines showed the lowest mortality risk (aHR 0.55, 95% CI 0.40–0.75, p < 0.001).
Statin initiation was associated with lower risk of all-cause mortality in statin-naïve ESKD patients. As indication bias may be present in observational study setting, further prospective studies are warranted to validate the association of statin initiation with mortality in incident dialysis cases.
- Files in This Item
- There are no files associated with this item.
- Appears in
- 2. Clinical Science > Department of Nephrology and Hypertension > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.