title: Statins Improve Long Term Patency of Arteriovenous Fistula for Hemodialysis.
abstract: The protective effects of statins against stenosis for permanent hemodialysis access have been repeatedly demonstrated in animal studies, but remain controversial in human studies. This study aims to evaluate the association between statin use and permanent hemodialysis access patency using a nationwide hemodialysis cohort. A total of 9862 pairs of statin users and non-users, matched by age and gender, were selected for investigation from 75404 new hemodialysis patients during 2000-2008. The effect of statins on permanent hemodialysis access patency was evaluated using Cox proportional hazards models. Compared with non-users, statin users had an overall 18% risk reduction in the composite endpoint in which angioplasty and recreation were combined (adjusted hazard ratio = 0.82 [95%CI, 0.78-0.87]) and 21% in recreation of permanent hemodialysis access (adjusted hazard ratio = 0.79 [95%CI, 0.69-0.80]). Specifically, the protective effect was found for arteriovenous fistula (adjusted hazard ratio = 0.78[95% CI, 0.73-0.82] for composite endpoint and 0.74 [95% CI, 0.69-0.80] for vascular recreation), but not for arteriovenous grafts (adjusted hazard ratio = 1.10 [95% CI, 0.98-1.24] and 0.94 [95% CI, 0.83-1.07]). Statins possess a protective effect for arteriovenous fistula against the recreation of permanent hemodialysis access. The results provide a pharmaco-epidemiologic link between basic research and clinical evidence.
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Department of Life Science, National Taiwan Normal University, Taipei, Taiwan.|Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Hao-Hsiang
authors.initials: HH
authors.lastname: Chang
authors.affiliation: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
authors.forename: Yu-Kang
authors.initials: YK
authors.lastname: Chang
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chia-Wen
authors.initials: CW
authors.lastname: Lu
authors.affiliation: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
authors.forename: Chi-Ting
authors.initials: CT
authors.lastname: Huang
authors.affiliation: Department of Life Science, National Taiwan Normal University, Taipei, Taiwan.
authors.forename: Chiang-Ting
authors.initials: CT
authors.lastname: Chien
authors.affiliation: Department of Medicine, National Taiwan University Hospital, Hsinchu branch, Hsinchu, Taiwan.
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.|Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.|Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.|Department of Health Services Administration, China Medical University, Taichung City, Taiwan.|Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsu
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D001166:Arteriovenous Shunt, Surgical; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D014654:Vascular Patency / Q000187:drug effects*
chemical_list: D000924:Anticholesteremic Agents