Taking a statin before undergoing major elective surgery may reduce potentially serious kidney complications, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (2011;22:939-946).
Animal studies have suggested that statins can ameliorate ischemic renal injury, but whether a similar benefit occurs in human beings is unknown. Amber Molnar, MD, of the University of Western Ontario and Lawson Health Research Institute in London, Ontario, and her colleagues studied 213,347 patients who underwent major elective surgery in Ontario from 1995 to 2008.
Surgeries included cardiac, thoracic, vascular, intra-abdominal, and retroperitoneal procedures. Post-operative acute kidney injury (AKI) developed in 4,020 patients (1.9%) within two weeks of surgery. A total of 1,173 patients (0.5%) required dialysis within two weeks post-operatively and 5,974 patients (2.8%) died within a month of surgery.
Prior to surgery, 67,941 patients (32%) were taking a statin. After adjusting for patient and surgical characteristics, statin use was associated with 16% reduced risk of AKI, a 17% reduced risk of requiring acute dialysis, and a 21% reduced risk of dying compared with patients who were not taking a statin.
“Our study suggests that statin use in older persons results in less kidney injury following major elective surgery and reduces the risk of premature death after surgery,” Dr. Molnar said.
Additionally, the researchers found evidence of a dose-effect, with patients on higher-potency statins having less kidney injury. Of the 67,941 statin users, 37,627 (55%) were on low-potency statins and 25,454 (37%) were on high-potency statins. Statins were beneficial whether they were started more than 90 days or less than 30 days prior to surgery.