NATURE REVIEWS | NEPHROLOGY VOLUME 9 | JUNE 2013

Nature Reviews Nephrology 9, 309 (2013); published online 9 April 2013; doi:10.1038/nrneph.2013.68

RESEARCH HIGHLIGHTS

Use of high-potency statins has been shown to be more effective in improving cardiovascular outcomes than use of lower-potency statins. However, new findings from a retrospective observational study adds to data suggesting that high-potency statin therapy might increase the risk of acute kidney injury (AKI).

To compare the effects of treatment with high-potency versus low-potency statins on risk of AKI, Colin Dormuth and colleagues analysed the administrative healthcare records of more than 2 million people aged ≥40 years who received new prescriptions for statins during the study period. They found that during the first 120 days of treatment, patients without chronic kidney disease (CKD; n = 2,008,003) who received high-potency statins had a 34% higher risk of AKI hospitalizations than those who received low-potency statins (fixed effect rate ratio 1.34, 95% CI 1.25–1.43). This risk remained increased for at least the

ACUTE KIDNEY INJURY

High-potency statin therapy and risk of acute kidney injury

first 2 years of statin therapy. In patients with CKD (n = 59,636), the use of high-potency versus low-potency statins did not significantly increase the risk of hospitalization for AKI.

The researchers suggest that high-potency statin therapy might increase the risk of rhabdomyolysis and proteinuria, suppress production of the renoprotective antioxidant coenzyme Q10 and have other pleiotropic effects. They state that further studies are necessary to investigate these potential mechanisms and to identify patients for whom the cardiovascular benefits of high-potency versus low-potency statin therapy might be outweighed by an increased risk of adverse renal effects.

Ellen F. Carney

Original article Dormuth, C. R. et al. Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administrative databases. BMJ doi:10.1136/bmj.f880

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