Abstract 18501: Pre-Dialysis Transition High vs Moderate Dose Statin Use and Post-Dialysis Transition All-Cause Mortality

    loading  Checking for direct PDF access through Ovid


Introduction: Prior randomized control trials have suggested that statin use may be beneficial in non-dialysis dependent chronic kidney disease patients, but exhibits a lack of benefit for dialysis patients and that high dose statins have added benefit compared to moderate dose statins in patients with pre-existent heart disease. Yet, there is a paucity of data on whether high vs moderate dose statins initiated prior to transition to end-stage renal disease (ESRD) exhibit a benefit on post-ESRD survival.

Methods: We investigated a cohort of 21,104 US veterans on high or moderate dose statins for at least half of the one year prior to ESRD transition in 2007-2014. We examined the association of high vs moderate (ref.) dose statin use with early 6-month post-ESRD all-cause mortality after adjustment for demographics and comorbidities, including diabetes (DM) and atherosclerotic cardiovascular disease, and across subgroups.

Results: Patients were 72±10 years old, 3% female, and 75% diabetic. High dose statin patients composed 12.5% of the cohort, and had a lower crude 6-month death rate than moderate dose patients (31.4 vs 39.1 deaths per 100 person-years, respectively). Compared to moderate dose statin patients, high dose statin patients had better survival (HR[95%CI]: 0.90[0.81, 1.00]). This relationship was similar across all strata, and was particularly protective among patients with DM, and without ischemic heart disease, congestive heart failure, or prior myocardial infarction.

Conclusions: Incident ESRD patients on a high dose statin prior to transition have better post-ESRD transition survival compared to patients on a moderate dose. This was paradoxically evident among patients without pre-existing heart disease, thus possibly identifying patients where a high dose statin is beneficial prior to ESRD transition. Further studies are needed to investigate this relationship and examine the safety of high vs moderate dose statins in predialysis patients.

Related Topics

    loading  Loading Related Articles