Pre-Treatment Statins Reduce Acute Kidney Injury (AKI) Risk
Review shows reduction in AKI with high-dose statins versus low-dose or placebo.
For patients undergoing coronary angiography, pretreatment with high-dose statins reduces the risk of contrast-induced acute kidney injury (CIAKI), according to a meta-analysis published in The American Journal of Cardiology.
Anene Ukaigwe, M.D., from the Reading Health System in Pennsylvania, and colleagues conducted a systematic review and meta-analysis of randomized controlled trials of short-term high-dose statins for CIAKI prevention in patients undergoing coronary angiography. Data were included from 12 randomized controlled trials involving 5,564 patients.
The researchers found that CIAKI occurred in 3.4 percent of patients pretreated with high-dose statins and in 7.6 percent of those pretreated with low-dose statin or placebo (odds ratio, 0.43; P < 0.001). In subgroup analysis, the correlation persisted for patients with diabetes (odds ratio, 0.60; P = 0.004) and in patients with documented renal insufficiency (creatinine clearance <60 ml/min/m²; odds ratio, 0.66; P = 0.03).
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"In conclusion, pretreatment with high-dose statins, compared with low-dose statins or placebo, in patients undergoing coronary angiography reduces the incidence of CIAKI," the authors write. "This benefit was seen irrespective of the presence of diabetes and chronic kidney disease. Future studies should identify optimum dosing protocols for each statin."