Preoperative Statins and Acute Kidney Injury After Cardiac Surgery: Utilization of a Consensus Definition of Acute Kidney Injury
- Resource Type
- Authors
- Lindsey M Uhrin; John Guzek; Scott Bolesta
- Source
- Annals of Pharmacotherapy. 45:23-30
- Subject
- Male
Nephrology
medicine.medical_specialty
medicine.medical_treatment
Statistics as Topic
Medical Records
law.invention
Cohort Studies
Postoperative Complications
Risk Factors
law
Internal medicine
Preoperative Care
medicine
Cardiopulmonary bypass
Humans
Pharmacology (medical)
Renal replacement therapy
Cardiac Surgical Procedures
Aged
Retrospective Studies
Kidney
Cardiopulmonary Bypass
business.industry
Incidence
Acute kidney injury
Acute Kidney Injury
Middle Aged
Pennsylvania
medicine.disease
Surgery
Cardiac surgery
medicine.anatomical_structure
Practice Guidelines as Topic
Cohort
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Kidney disease
- Language
- ISSN
- 1542-6270
1060-0280
Background Previous trials investigating preoperative statin use for prevention of acute kidney injury following cardiovascular surgery were limited to patients undergoing a specific procedure and many used nonconsensus definitions of acute kidney injury. Objective To use a consensus definition of acute kidney injury for evaluating the association of preoperative statin use with the development of acute kidney injury following cardiac surgery utilizing cardiopulmonary bypass. Methods We retrospectively evaluated a cohort of 667 patients ≥18 years who underwent any cardiac surgery on cardiopulmonary bypass between April 2007 and May 2009 at Mercy Hospital in Scranton, PA. Patients were excluded if they were receiving preoperative renal replacement therapy, had stage 5 chronic kidney disease, or did not have a postoperative serum creatinine level assessed. The primary outcome was the odds of developing acute kidney injury given the use of preoperative statins. Acute kidney injury was defined based on the Acute Kidney Injury Network criteria as either an absolute increase in serum creatinine of ≥0.3 mg/dL or 1.5 times baseline, or the need for postoperative renal replacement therapy. Results: The final analysis included 563 patients; 356 were receiving preoperative statins. The incidence of acute kidney injury was 35.1% in the statin group and 26.1% in the non-statin group. On univariate analysis statins were associated with an increase in the odds of acute kidney injury (OR 1.53; 95% CI 1.05 to 2.24). Multivariate logistic regression did not demonstrate an association of statins with acute kidney injury (OR 1.36; 95% CI 0.904 to 2.05). Repeating the analysis using 312 propensity score–matched patients also showed no association of statins with acute kidney injury (OR 1.17; 95% CI 0.715 to 1.93). Conclusions: Our findings do not support the hypothesis that preoperative statin use is associated with a decrease in the incidence of acute kidney injury following cardiac surgery utilizing cardiopulmonary bypass.