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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
A Target Trial Emulation to Investigate Kidney Protection from Statin Initiation in Adults with Normal Kidney
Franco W T Cheng1,2, Ivy L Mak3, Zoey C T Wong3
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Summary
Statin initiation in adults with normal kidney function showed modest benefits, reducing kidney function impairment and all-cause mortality. These findings support statins
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Conflicting evidence exists regarding statin use and kidney health in individuals with normal kidney function.
- Some studies suggest kidney protection, while others indicate a risk of acute kidney injury.
- This study investigates the impact of initiating statin therapy on kidney function in adults with previously normal kidney function.
Purpose of the Study:
- To evaluate the effect of statin initiation on kidney function in adults with normal estimated glomerular filtration rate (eGFR).
- To assess the association between statin use and risks of kidney function impairment and all-cause mortality.
- To determine if statins offer kidney protective benefits in this population.
Main Methods:
- A sequential target trial emulation using electronic health records from Hong Kong.
- Inclusion of adults (≥18 years) with normal kidney function (eGFR ≥60 mL/min/1.73 m²) meeting statin indications.
- 1:1 propensity score matching between statin initiators and non-initiators, with outcomes analyzed using weighted pooled logistic regression.
Main Results:
- Statin use was linked to reduced risks of severe kidney function impairment (eGFR <15 and <60 mL/min/1.73 m²) and significant eGFR decline (≥30% and ≥50%).
- A statistically significant reduction in all-cause mortality was observed in statin initiators.
- Hazard ratios indicated a protective effect, with absolute risk reductions reported for all key outcomes.
Conclusions:
- Statin initiation in adults with normal kidney function is associated with a modest decrease in all-cause mortality.
- The findings suggest a potential kidney protective benefit of statins in this population.
- Statin therapy did not appear to increase the risk of adverse kidney outcomes.
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