title: Statin use associates with a lower incidence of acute kidney injury after major elective surgery.
abstract: Statins abrogate ischemic renal injury in animal studies but whether they are renoprotective in humans is unknown. We conducted a population-based retrospective cohort study that included 213,347 older patients who underwent major elective surgery in the province of Ontario, Canada from 1995 to 2008. During the first 14 postoperative days, 1.9% (4020 patients), developed acute kidney injury and 0.5% (1173 patients), required acute dialysis. The 30-day mortality rate was 2.8% (5974 patients). Prior to surgery, 32% of patients were taking a statin. After statistical adjustment for patient and surgical characteristics, statin use associated with 16% lower odds of acute kidney injury (OR, 0.84; 95% CI, 0.79 to 0.90), 17% lower odds of acute dialysis (OR, 0.83; 95% CI, 0.72 to 0.95), and 21% lower odds of mortality (OR, 0.79; 95% CI, 0.74 to 0.85). Propensity score matching produced similar results. These data suggest that statins may protect against renal complications after major elective surgery and reduce perioperative mortality.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Western Ontario, London, Canada.
authors.forename: Amber O
authors.initials: AO
authors.lastname: Molnar
authors.forename: Steven G
authors.initials: SG
authors.lastname: Coca
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Devereaux
authors.forename: Arsh K
authors.initials: AK
authors.lastname: Jain
authors.forename: Abhijat
authors.initials: A
authors.lastname: Kitchlu
authors.forename: Jin
authors.initials: J
authors.lastname: Luo
authors.forename: Chirag R
authors.initials: CR
authors.lastname: Parikh
authors.forename: J Michael
authors.initials: JM
authors.lastname: Paterson
authors.forename: Nausheen
authors.initials: N
authors.lastname: Siddiqui
authors.forename: Ron
authors.initials: R
authors.lastname: Wald
authors.forename: Michael
authors.initials: M
authors.lastname: Walsh
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
mesh_terms: D058186:Acute Kidney Injury / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors