Statins may reduce the risk for contrast-induced acute kidney injury, according to investigators presenting at Kidney Week 2022, the annual meeting of the American Society of Nephrology, in Orlando, Florida.
“Statins have multiple pleiotropic effects such as anti-inflammatory, antithrombotic, and antioxidative effects that may attenuate kidney injury after iodinated contrast exposure,” Sankar D. Navaneethan, MD, MS, MPH, of Baylor College of Medicine in Houston, Texas, told Renal & Urology News. “Further, some studies have also suggested that statins may reduce tubular reabsorption of contrast media, thereby potentially reducing direct toxic effects.”
Dr Navaneethan and colleagues performed a systematic review and meta-analysis of 7 randomized clinical trials comparing statins to placebo. The trials included 6635 patients. Statin use was significantly associated with a 41% reduction in the risk of contrast-induced acute kidney injury, but did not affect the rate of contrast-induced acute kidney injury warranting dialysis.
The investigators also compared high- vs lose-dose statins across 2 trials that included 1204 patients. High-dose statins did not perform significantly better than low-dose statins in lowering the incidence of contrast-induced acute kidney injury, but a larger trial is still warranted, according to Dr Navaneethan.
“It is unclear if the effects of statins on contrast induced AKI is dose dependent. While high dose statins may offer beneficial effects, they could also lead to adverse effects.”
Statins are recommended for all patients older than 50 years with chronic kidney disease for cardiovascular disease risk reduction, Dr Navaneethan noted. Statins may be considered for anyone requiring coronary angiography or percutaneous coronary intervention, along with other standard of care measures to reduce contrast-induced kidney injury.
Chittoor S, Kohli K, Navaneethan SD, et al. Statins and contrast induced-AKI: A systematic review and meta-analysis. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Abstract FR-PO100.