title: Statins for the prevention of contrast-induced acute kidney injury.
abstract: Acute kidney injury (AKI) is a common medical problem, especially in patients undergoing cardiovascular procedures. The risk of kidney damage has multiple determinants and is often related to or exacerbated by intravenous or intra-arterial iodinated contrast. Contrast-induced AKI (CI-AKI) has been associated with an increased risk of subsequent myocardial infarction, stroke, the development of heart failure, rehospitalization, progression of chronic kidney disease, end-stage renal disease, and death. Statins have been studied extensively in the setting of chronic kidney disease and they have been shown to reduce albuminuria, but they have had no effect on the progressive reduction of glomerular filtration or the need for renal replacement therapy. Several meta-analyses have shown a protective effect of short-term statin administration on CI-AKI and led to two large randomized controlled trials evaluating the role of rosuvastatin in the prevention of CI-AKI in high-risk patients with acute coronary syndrome and diabetes mellitus. Both trials showed a benefit of rosuvastatin prior to contrast administration in a statin-naive patient population. In aggregate, these studies support the short-term use of statins specifically for the prevention of CI-AKI in patients undergoing coronary angiography with or without percutaneous coronary intervention.
authors.affiliation: Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Tex., USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Ball
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D000419:Albuminuria / Q000139:chemically induced; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D005464:Fluorobenzenes / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008658:Inactivation, Metabolic / Q000187:drug effects; D007684:Kidney Tubules / Q000187:drug effects / Q000378:metabolism; D008074:Lipoproteins / Q000378:metabolism; D015201:Meta-Analysis as Topic; D032342:Muscle Cells / Q000187:drug effects; D062645:Percutaneous Coronary Intervention; D011743:Pyrimidines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000517:prevention & control; D017582:Renal Replacement Therapy; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000150:complications; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D003287:Contrast Media; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D003404:Creatinine