title: High-potency statins increase the risk of acute kidney injury: evidence from a large population-based study.
abstract: OBJECTIVE
  To assess the association between acute kidney injury and exposure to either high-potency statins or low-potency statins.
  
  
  METHODS
  A population-based, nested case-control study was performed on a cohort of 316,449 patients from Lombardy (Italy) newly treated with statins between 2007 and 2010 aged 40 years or older. 458 patients experienced acute kidney injury within six months after initial statin prescription. Up to four controls were randomly selected for each case. Logistic regression was used to model the outcome risk associated with high-potency contrasted with low-potency statins dispensed at starting therapy, and during follow-up.
  
  
  RESULTS
  Patients at whom high-potency statins were initially dispensed were more likely to be hospitalized for acute kidney injury within six months after starting treatment than those on low-potency statins (adjusted OR 1.54, 95% confidence interval 1.25-1.91). Patients receiving high-potency statins within three weeks before the outcome onset had a significant increased risk respect to those who did not receive statins during the same time-window (adjusted OR 1.45, 95% confidence interval 1.04-2.03). When follow-up was extended from 6 months to 12 months the difference was not significant anymore (adjusted OR 1.17, 95% confidence interval 0.89-1.54).
  
  
  CONCLUSIONS
  Use of high-potency statins is associated with an increased risk of acute kidney injury compared with low-potency statins in the first 6 months after starting therapy.
authors.affiliation: Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy. Electronic address: giovanni.corrao@unimib.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrao
authors.affiliation: Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Soranna
authors.affiliation: Centre of Epidemiology and Preventive Pharmacology (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milano, Milan, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Casula
authors.affiliation: Operative Unit of Territorial Health Services, Region Lombardia, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.affiliation: Division of Paediatric Nephrology, Paediatric Hospital "Regina Margherita", Turin, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Porcellini
authors.affiliation: Centre of Epidemiology and Preventive Pharmacology (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milano, Milan, Italy; IRCSS Multimedica, Milan, Italy.
authors.forename: Alberico L
authors.initials: AL
authors.lastname: Catapano
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000453:epidemiology*; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Databases; Drug safety; High-potency; Kidney injury; Low-potency; Nested case-control study; Statins