The Association Between Statin Use and Risk of Chronic Kidney Disease in Community-Dwelling Older People in Shanghai, China

Miaomiao Zhao; Longbing Ren; Zhitong Zhou; Tao Wang; Jue Li

doi:10.2147/CLEP.S360395

The Association Between Statin Use and Risk of Chronic Kidney Disease in Community-Dwelling Older People in Shanghai, China

Clin Epidemiol. 2022 Jun 25:14:779-788. doi: 10.2147/CLEP.S360395. eCollection 2022.

Authors

Miaomiao Zhao^{1

2}, Longbing Ren³, Zhitong Zhou³, Tao Wang³, Jue Li²

Affiliations

¹ School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China.
² Department of Epidemiology, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, People's Republic of China.
³ Institute of Clinical Epidemiology and Evidence-Based Medicine, Tongji University School of Medicine, Shanghai, People's Republic of China.

Abstract

Purpose: The effects of statins on renal outcomes have already been studied in patients with chronic kidney disease (CKD); however, data on the general population are limited. We evaluated the association between statin use and risk of CKD in community-dwelling older people in Shanghai, China.

Patients and methods: This registry-based cohort study was conducted in four communities in four districts in Shanghai. Participants with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m² in 2016 were eligible for the study, and new-onset CKD in 2017, 2018, and 2019 was recorded. Poisson generalized linear models were conducted to examine the relationships among statin therapy, dyslipidemia, and CKD; linear mixed-effects models were conducted to examine the relationships between statin therapy and changes in eGFR. All analyses were performed with both conventional adjustment and propensity score-matching methods.

Results: Of the study cohort of 2455 participants (41.1% men; average age, 68.06 years), 624 (25.4%) were treated with stains. Two propensity score-matched cohorts of 604 participants each were analyzed (statin users and nonusers). Statin use was significantly associated with a decreased risk of new-onset CKD with hazard ratios (HRs) and 95% confidence intervals (CIs) of 0.73 (0.59 to 0.91) (p<0.01) in the unmatched cohort and 0.75 (0.59 to 0.97) (p=0.02) in the matched cohort. There were significant differences in the eGFR decline between statin users and nonusers from baseline to 3 years in the unmatched and matched cohorts (both p<0.05). In addition, both statin users and nonusers with dyslipidemia experienced more new-onset CKD (both p<0.05).

Conclusion: Statin use was significantly associated with a decreased risk of new-onset CKD and a slower decline in eGFR in community-dwelling older people. Meanwhile, dyslipidemia was a risk factor for CKD progression among both statin users and nonusers.

Keywords: chronic kidney disease; community-dwelling older people; dyslipidemia; statins.

Grants and funding

The research was funded by National Natural Science Foundation of China (82003540), Three-Year ActionProgram of Shanghai Municipality for Strengthening the Construction of Public Health System (GWV-10.2-YQ39), Special Project for Clinical Research in Health Industry of Shanghai Municipal Health Commission (20194Y0116), and Academic Mentorship for Scientific Research Cadre Project of Shanghai University of Medicine and Health Sciences.