Association of statin use with risk and outcome of acute kidney injury in Community-acquired pneumonia

Raghavan Murugan, Lisa Weissfeld, Sachin Yende, Kai Singbartl, Derek C. Angus, John A. Kellum

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background and objectives Sepsis is a leading cause of AKI. Animal studies suggest that the pleiotropic effect of statins attenuates the risk for AKI and decreases mortality. This study examined whether statin use was associated with a lower risk for pneumonia-induced AKI and 1-year and cause-specific mortality in patients with AKI. Design, setting, participants, & measurements Multicenter, prospective cohort study of 1836 patients hospitalized with community-acquired pneumonia. Results: Baseline characteristics differed among statin users and nonusers. Of the 413 patients (22.5%) who received a statin before hospitalization, statin treatment, when adjusted for differences in age, severity of pneumonia, admission from nursing home, health insurance, and propensity for statin use, did not reduce the risk for AKI (odds ratio [OR], 1.32 [95% confidence interval (CI), 1.02-1.69]; P=0.05). Of patients with AKI (n=631), statin use was associated with a lower risk for death at 1 year (27.8% versus 38.8%; P=0.01), which was not significant when adjusted for differences in age, severity of pneumonia and AKI, use of mechanical ventilation, and propensity score (OR, 0.72 [95% CI, 0.50-1.06]; P=0.09). Among patients with AKI, cardiovascular disease accounted for one third of all deaths. Conclusions: In a large cohort of patients hospitalized with pneumonia, statins did not reduce the risk for AKI. Among patients with AKI, statin use was not associated with lower risk for death at 1 year. The higher risk for AKI observed among statin users may be due to indication bias.

Original languageEnglish (US)
Pages (from-to)895-905
Number of pages11
JournalClinical Journal of the American Society of Nephrology
Volume7
Issue number6
DOIs
StatePublished - Jun 1 2012

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Acute Kidney Injury
Pneumonia
Odds Ratio
Confidence Intervals
Propensity Score
Mortality
Health Insurance
Nursing Homes
Artificial Respiration
Sepsis
Hospitalization
Cohort Studies
Cardiovascular Diseases
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Murugan, Raghavan ; Weissfeld, Lisa ; Yende, Sachin ; Singbartl, Kai ; Angus, Derek C. ; Kellum, John A. / Association of statin use with risk and outcome of acute kidney injury in Community-acquired pneumonia. In: Clinical Journal of the American Society of Nephrology. 2012 ; Vol. 7, No. 6. pp. 895-905.
@article{e94f5ca4e09a41d8904fc4935cef7959,
title = "Association of statin use with risk and outcome of acute kidney injury in Community-acquired pneumonia",
abstract = "Background and objectives Sepsis is a leading cause of AKI. Animal studies suggest that the pleiotropic effect of statins attenuates the risk for AKI and decreases mortality. This study examined whether statin use was associated with a lower risk for pneumonia-induced AKI and 1-year and cause-specific mortality in patients with AKI. Design, setting, participants, & measurements Multicenter, prospective cohort study of 1836 patients hospitalized with community-acquired pneumonia. Results: Baseline characteristics differed among statin users and nonusers. Of the 413 patients (22.5{\%}) who received a statin before hospitalization, statin treatment, when adjusted for differences in age, severity of pneumonia, admission from nursing home, health insurance, and propensity for statin use, did not reduce the risk for AKI (odds ratio [OR], 1.32 [95{\%} confidence interval (CI), 1.02-1.69]; P=0.05). Of patients with AKI (n=631), statin use was associated with a lower risk for death at 1 year (27.8{\%} versus 38.8{\%}; P=0.01), which was not significant when adjusted for differences in age, severity of pneumonia and AKI, use of mechanical ventilation, and propensity score (OR, 0.72 [95{\%} CI, 0.50-1.06]; P=0.09). Among patients with AKI, cardiovascular disease accounted for one third of all deaths. Conclusions: In a large cohort of patients hospitalized with pneumonia, statins did not reduce the risk for AKI. Among patients with AKI, statin use was not associated with lower risk for death at 1 year. The higher risk for AKI observed among statin users may be due to indication bias.",
author = "Raghavan Murugan and Lisa Weissfeld and Sachin Yende and Kai Singbartl and Angus, {Derek C.} and Kellum, {John A.}",
year = "2012",
month = "6",
day = "1",
doi = "10.2215/CJN.07100711",
language = "English (US)",
volume = "7",
pages = "895--905",
journal = "Clinical journal of the American Society of Nephrology : CJASN",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "6",

}

Association of statin use with risk and outcome of acute kidney injury in Community-acquired pneumonia. / Murugan, Raghavan; Weissfeld, Lisa; Yende, Sachin; Singbartl, Kai; Angus, Derek C.; Kellum, John A.

In: Clinical Journal of the American Society of Nephrology, Vol. 7, No. 6, 01.06.2012, p. 895-905.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association of statin use with risk and outcome of acute kidney injury in Community-acquired pneumonia

AU - Murugan, Raghavan

AU - Weissfeld, Lisa

AU - Yende, Sachin

AU - Singbartl, Kai

AU - Angus, Derek C.

AU - Kellum, John A.

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background and objectives Sepsis is a leading cause of AKI. Animal studies suggest that the pleiotropic effect of statins attenuates the risk for AKI and decreases mortality. This study examined whether statin use was associated with a lower risk for pneumonia-induced AKI and 1-year and cause-specific mortality in patients with AKI. Design, setting, participants, & measurements Multicenter, prospective cohort study of 1836 patients hospitalized with community-acquired pneumonia. Results: Baseline characteristics differed among statin users and nonusers. Of the 413 patients (22.5%) who received a statin before hospitalization, statin treatment, when adjusted for differences in age, severity of pneumonia, admission from nursing home, health insurance, and propensity for statin use, did not reduce the risk for AKI (odds ratio [OR], 1.32 [95% confidence interval (CI), 1.02-1.69]; P=0.05). Of patients with AKI (n=631), statin use was associated with a lower risk for death at 1 year (27.8% versus 38.8%; P=0.01), which was not significant when adjusted for differences in age, severity of pneumonia and AKI, use of mechanical ventilation, and propensity score (OR, 0.72 [95% CI, 0.50-1.06]; P=0.09). Among patients with AKI, cardiovascular disease accounted for one third of all deaths. Conclusions: In a large cohort of patients hospitalized with pneumonia, statins did not reduce the risk for AKI. Among patients with AKI, statin use was not associated with lower risk for death at 1 year. The higher risk for AKI observed among statin users may be due to indication bias.

AB - Background and objectives Sepsis is a leading cause of AKI. Animal studies suggest that the pleiotropic effect of statins attenuates the risk for AKI and decreases mortality. This study examined whether statin use was associated with a lower risk for pneumonia-induced AKI and 1-year and cause-specific mortality in patients with AKI. Design, setting, participants, & measurements Multicenter, prospective cohort study of 1836 patients hospitalized with community-acquired pneumonia. Results: Baseline characteristics differed among statin users and nonusers. Of the 413 patients (22.5%) who received a statin before hospitalization, statin treatment, when adjusted for differences in age, severity of pneumonia, admission from nursing home, health insurance, and propensity for statin use, did not reduce the risk for AKI (odds ratio [OR], 1.32 [95% confidence interval (CI), 1.02-1.69]; P=0.05). Of patients with AKI (n=631), statin use was associated with a lower risk for death at 1 year (27.8% versus 38.8%; P=0.01), which was not significant when adjusted for differences in age, severity of pneumonia and AKI, use of mechanical ventilation, and propensity score (OR, 0.72 [95% CI, 0.50-1.06]; P=0.09). Among patients with AKI, cardiovascular disease accounted for one third of all deaths. Conclusions: In a large cohort of patients hospitalized with pneumonia, statins did not reduce the risk for AKI. Among patients with AKI, statin use was not associated with lower risk for death at 1 year. The higher risk for AKI observed among statin users may be due to indication bias.

UR - http://www.scopus.com/inward/record.url?scp=84862189046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862189046&partnerID=8YFLogxK

U2 - 10.2215/CJN.07100711

DO - 10.2215/CJN.07100711

M3 - Article

C2 - 22461537

AN - SCOPUS:84862189046

VL - 7

SP - 895

EP - 905

JO - Clinical journal of the American Society of Nephrology : CJASN

JF - Clinical journal of the American Society of Nephrology : CJASN

SN - 1555-9041

IS - 6

ER -