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Ann Thorac Surg. 2014 Jun;97(6):2081-7. doi: 10.1016/j.athoracsur.2014.02.033. Epub 2014 Apr 12.

Association between preoperative statin use and acute kidney injury biomarkers in cardiac surgical procedures.

Author information

  • 1Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
  • 2Section of Nephrology, Yale University School of Medicine, Veterans Affairs CT Healthcare System, and the Program of Applied Translational Research, New Haven, Connecticut; Department of Medicine, Veterans Affairs Medical Center, West Haven, Connecticut. Electronic address: chirag.parikh@yale.edu.
  • 3Section of Nephrology, Yale University School of Medicine, Veterans Affairs CT Healthcare System, and the Program of Applied Translational Research, New Haven, Connecticut.
  • 4Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.
  • 5Section of Nephrology, Department of Medicine, University of Chicago, Pritzker School of Medicine, Chicago, Illinois.
  • 6Division of General Internal Medicine, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, California.
  • 7Division of Cardiac Surgery, Western University, London, Ontario, Canada.
  • 8Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Acute kidney injury (AKI) is a serious complication of cardiac operations for which there remains no specific therapy. Animal data and several observational studies suggest that statins prevent AKI, but the results are not conclusive, and many studies are retrospective in nature.

METHODS:

We conducted a multicenter prospective cohort study of 625 adult patients undergoing elective cardiac operations. All patients were taking statins and were grouped according to whether statins were continued or held in the 24 hours before operation. The primary outcome was AKI as defined by a doubling of serum creatinine or dialysis. The secondary outcome was the peak level of several kidney injury biomarkers. The results were adjusted for demographic and clinical factors.

RESULTS:

Continuing (vs holding) a statin before operation was not associated with a lower risk of AKI, as defined by a doubling of serum creatinine or dialysis (adjusted relative risk [RR] 1.09; 95% confidence interval [CI] 0.44, 2.70). However, continuing a statin was associated with a lower risk of elevation of the following AKI biomarkers: urine interleukin-18, urine neutrophil gelatinase-associated lipocalin, urine kidney injury molecule-1, and plasma neutrophil gelatinase-associated lipocalin (adjusted RR 0.34; 95% CI 0.18, 0.62), (adjusted RR 0.41; 95% CI 0.22, 0.76), (adjusted RR 0.37; 95% CI 0.20, 0.76), (adjusted RR 0.62; 95% CI 0.39, 0.98), respectively.

CONCLUSIONS:

Statins may prevent kidney injury after cardiac operations, as evidenced by lower levels of kidney injury biomarkers.

Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Comment in

  • Invited commentary. [Ann Thorac Surg. 2014]
PMID:
24725831
[PubMed - indexed for MEDLINE]
PMCID:
PMC4068122
[Available on 2015/6/1]
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