title: Statin use and calcific uremic arteriolopathy: a matched case-control study.
abstract: BACKGROUND
  Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is characterized by vascular calcification, thrombosis and intense inflammation. Prior research has shown that statins have anticalcification, antithrombotic and antiinflammatory properties; however, the association between statin use and CUA has not been investigated.
  
  
  METHODS
  This matched case-control study included 62 adult maintenance hemodialysis (HD) patients with biopsy-confirmed CUA diagnosed between the years 2002 and 2011 (cases). All cases were hospitalized at the time of diagnosis. Controls (n = 124) were hospitalized maintenance HD patients without CUA (matched to cases by gender and timing of hospitalization). Univariate and multivariable logistic regression models were applied to compute odds ratio (OR) and 95% confidence intervals (CI) for CUA in statin users, and also to examine previously described associations.
  
  
  RESULTS
  The mean age of cases was 58 years. Most were females (68%), and of white race (64%). Statin use was more common in controls than in cases (39 vs. 19%, p < 0.01). Statin use was associated with lower odds of CUA in unadjusted (OR 0.38, 95% CI 0.18-0.79) and adjusted (OR 0.20, 95% CI 0.05-0.88) analyses. Hypercalcemia (OR 2.25, 95% CI 1.14-4.43), hypoalbuminemia (OR 5.73, 95% CI 2.79-11.77), calcitriol use (OR 5.69, 95% CI 1.02-31.77) and warfarin use (OR 4.30, 95% CI 1.57-11.74) were positively associated with CUA in adjusted analyses whereas paricalcitol and doxercalciferol were not (OR 1.33, 95% CI 0.54-3.27).
  
  
  CONCLUSIONS
  Statin use may be negatively associated with odds of CUA. Further large prospective studies with attention to potential confounders are needed to confirm these findings.
authors.affiliation: Division of Nephrology, Dermatopathology Unit, Massachusetts General Hospital, Boston, MA 02114, USA. sagarnigs@gmail.com
authors.forename: Sagar U
authors.initials: SU
authors.lastname: Nigwekar
authors.forename: Ishir
authors.initials: I
authors.lastname: Bhan
authors.forename: Alexander
authors.initials: A
authors.lastname: Turchin
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Skentzos
authors.forename: Reza
authors.initials: R
authors.lastname: Hajhosseiny
authors.forename: David
authors.initials: D
authors.lastname: Steele
authors.forename: Rosalynn M
authors.initials: RM
authors.lastname: Nazarian
authors.forename: Julia
authors.initials: J
authors.lastname: Wenger
authors.forename: Samir
authors.initials: S
authors.lastname: Parikh
authors.forename: Ananth
authors.initials: A
authors.lastname: Karumanchi
authors.forename: Ravi
authors.initials: R
authors.lastname: Thadhani
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017445:Skin Diseases, Vascular / Q000209:etiology / Q000517:prevention & control*; D014511:Uremia / Q000150:complications*; D061205:Vascular Calcification / Q000209:etiology / Q000517:prevention & control*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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