Trends in Statin Use Among US Adults With Chronic Kidney Disease, 1999-2014

J Am Heart Assoc. 2019 Jan 22;8(2):e010640. doi: 10.1161/JAHA.118.010640.

Abstract

Background The 2013 American College of Cardiology/American Heart Association cholesterol guidelines recognize cardiovascular disease and diabetes mellitus but not chronic kidney disease ( CKD ) as high-risk conditions warranting statin therapy. Statin use may be lower for adults with CKD compared with adults with conditions that have guideline indications for statin use. Methods and Results We analyzed data from the National Health and Nutrition Examination Surveys from 1999-2002 through 2011-2014 to determine trends in the percentage of US adults ≥20 years of age with and without CKD taking statins. CKD was defined by an estimated glomerular filtration rate <60 mL/min per 1.73m2 or albumin-to-creatinine ratio ≥30 mg/g. Statin use was identified through a medication inventory. Between 1999-2002 and 2011-2014, the percentage of adults taking statins increased from 17.6% to 35.7% among those with CKD and from 6.8% to 14.7% among those without CKD . After multivariable adjustment, adults with CKD were not more likely to be taking statins compared with those without CKD (prevalence ratio, 1.01; 95% CI] 0.96-1.08). Among adults without a history of cardiovascular disease, those with CKD but not diabetes mellitus were less likely to be taking statins compared with those with diabetes mellitus but not CKD (prevalence ratio, 0.54; 95% CI , 0.44-0.66). Among adults with a history of cardiovascular disease, there was no difference in statin use between those with CKD but not diabetes mellitus versus those with diabetes mellitus but not CKD (prevalence ratio, 0.95; 95% CI , 0.79-1.15). Conclusions CKD does not appear to be a major stimulus for statin use among US adults.

Keywords: chronic kidney disease; statin; trends.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Nutrition Surveys*
  • Prevalence
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / drug therapy
  • Renal Insufficiency, Chronic / physiopathology
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology
  • Young Adult

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors