title: The effects of preoperative statins on the incidence of postoperative acute kidney injury in patients undergoing cardiac surgeries.
abstract: OBJECTIVE
  Recent evidence has emphasized multifunctional therapeutic effects of statins on renal protection after cardiac surgeries. We aimed to assess the effects of preoperative administration of statins on lowering the incidence of postoperative acute kidney injury in patients undergoing cardiac surgeries.
  
  
  METHODS
  In a retrospective study, the preoperative, intraoperative and postoperative data of 1064 consecutive patients who underwent different forms of cardiovascular surgeries were reviewed. According to whether patients had received statins preoperatively, the patients were categorized into no statin (n = 620), low-dose statin (n = 262) or high-dose statin (n = 182) administration groups.
  
  
  RESULTS
  No difference was seen in postoperative incidence of acute kidney injury between the three groups (11.1, 9.9 and 11.5%, respectively, P = 0.887). The multivariate logistic regression analysis showed that advanced age [odds ratio (OR) = 1.043, P < 0.001], recent myocardial infarction within 90 days of surgery (OR = 1.935, P = 0.002) and longer intubation time (OR = 1.001, P = 0.001) could predict occurrence of kidney injury after cardiac surgery. The preoperative use of angiotensin converting enzyme (ACE) inhibitor could effectively prevent occurrence of this postoperative event (OR = 0.552, P = 0.008). After adjusting for propensity score only, statin treatment, at low or high doses, was not associated with lower postoperative acute kidney injury (OR = 1.010, P = 0.971 for low dose and OR = 1.108, P = 0.745 for high dose versus no statin). After further adjustment for propensity score, statin treatment with the different dosages was not associated with acute kidney injury (OR = 0.869, P = 0.633 for low dose and OR = 1.051, P = 0.885 for high dose versus no statin).
  
  
  CONCLUSIONS
  Preoperative statin use may not inhibit acute kidney injury after operation.
authors.affiliation: Department of Cardiothoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran nemati_mhs@yahoo.com.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Nemati
authors.affiliation: Department of Medical Journalism, Paramedical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Astaneh
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Acute kidney injury; Cardiac surgery; Dose; Risk; Statin