Statins May Help Renal Tx Patients

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New findings suggest transplant recipients who take these medications are at decreased risk of death

Statin use is associated with reduced mortality in kidney transplant recipients but not with prolonged graft survival, according to a new study.

Rainer Oberbauer, MD, professor of nephrology at the Medical University of Vienna in Austria, and colleagues investigated the effect of statin therapy on all-cause mortality and graft survival among renal transplant recipients. The study pooled data from 2,041 patients receiving their first kidney transplant between 1990 and 2003. At the time of transplantation, 302 patients (15%) were on statin therapy to lower cholesterol levels and 1,739 (85%) were not.

The researchers focused their analyses on 1,829 patients who were alive and had a functioning graft at day 90 after engraftment. In these subjects, the 12-year survival rates were 73% in statin users and 64% in non-users. When the investigators included in their analyses patients who died within the first 90 days after engraftment, 12-year survival was 72% in statin users and 61% in non-users.

After adjusting for confounders, statin use was associated with a significant 36% reduced risk of death from any cause compared with non-use. Of the 692 recipients who died more than 90 days after transplantation, 181 (26%) deaths were due to cardiac causes. Findings appear in the Journal of the American Society of Nephrology (2008; online ahead of print).

Further analysis showed that statin use was independently associated with prolonged patient survival, with cardiovascular risk factors and pre-existing CVD in the statin users being dominant variables.

In addition, 12-year functional graft survival after 90 days of engraftment was similar in the two groups: 76% among statin recipients and 70% in the non-statin group.

Studies of statin treatment in dialysis and renal transplant recipients have yielded conflicting results, and most other statin studies have excluded renal disease patients. “We now show that statin use in renal transplant recipients is associated with longer survival,” Dr. Oberbauer said.

He cautioned, however, that this observational study does not allow for any cause-and-effect conclusions. “The proof that statin use prolongs life can only be accomplished in a randomized controlled trial,” he said.

Study subjects were part of the Austrian Dialysis and Transplant Registry, which the researchers noted is “ideally suited for the assessment of drug effectiveness in this target population” because of the complete documentation of outcomes, cardiovascular medication, and patient comorbidities.

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