title: Pilot double-blind, randomized controlled trial of short-term atorvastatin for prevention of acute kidney injury after cardiac surgery.
abstract: OBJECTIVE
  To test whether short-term perioperative administration of oral atorvastatin could reduce incidence of postoperative acute kidney injury (AKI) in cardiac surgical patients.
  
  
  METHODS
  We conducted a double-blind, randomized controlled trial in 100 cardiac surgical patients at increased risk of postoperative AKI. Patients were randomized to atorvastatin (40 mg once daily for 4 days starting preoperatively) or identical placebo capsule. Primary outcome was to detect a smaller absolute rise in postoperative creatinine with statin therapy. Secondary outcomes included AKI defined by the creatinine criteria of RIFLE consensus classification (RIFLE R, I or F), change in urinary neutrophil gelatinase-associated lipocalin (NGAL) concentration, requirement for renal replacement therapy, length of stay in intensive care, length of stay in hospital and hospital mortality.
  
  
  RESULTS
  Study groups were well matched. For each patient maximal increase in creatinine during the 5 days after surgery was assessed; median maximal increase was 28 µmol/L in the atorvastatin group and 29.5 µmol/L in the placebo group (P = 0.62). RIFLE R or greater occurred in 26% of patients with atorvastatin and 32% with placebo (P = 0.65). Postoperatively urine NGAL changes were similar (median NGAL : creatinine ratio at intensive care unit admission: atorvastatin group 1503 ng/mg, placebo group 1101 ng/mg; P = 0.22). Treatment was well tolerated and adverse events were similar between groups.
  
  
  CONCLUSIONS
  Short-term perioperative atorvastatin use was not associated with a reduced incidence of postoperative AKI or smaller increases in urinary NGAL. (ClinicalTrials.gov NCT00910221).
authors: Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia.
authors: John R
authors: JR
authors: Prowle
authors: Paolo
authors: P
authors: Calzavacca
authors: Elisa
authors: E
authors: Licari
authors: Emmanuela V
authors: EV
authors: Ligabo
authors: Jorge E
authors: JE
authors: Echeverri
authors: Michael
authors: M
authors: Haase
authors: Anja
authors: A
authors: Haase-Fielitz
authors: Sean M
authors: SM
authors: Bagshaw
authors: Prasad
authors: P
authors: Devarajan
authors: Rinaldo
authors: R
authors: Bellomo
mesh_terms: D058186:Acute Kidney Injury / Q000517:prevention & control*; D000209:Acute-Phase Proteins / Q000652:urine; D000368:Aged; D000069059:Atorvastatin; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood / Q000652:urine; D004311:Double-Blind Method; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D011518:Proto-Oncogene Proteins / Q000652:urine; D011758:Pyrroles / Q000627:therapeutic use*
chemical_list: D000209:Acute-Phase Proteins; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D011758:Pyrroles; D000069059:Atorvastatin; D003404:Creatinine