Use of Statins in Patients Undergoing Peritoneal Dialysis

Kidney Week 2020

There are few data available on the efficacy of satin use in patients undergoing peritoneal dialysis. The majority of recent studies regarding satin use in patients on dialysis have included only those on hemodialysis or only a small number of patients on peritoneal dialysis. Hyung Woo Kim, PhD, and colleagues at Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea, recently conducted a study to examine the efficacy of statin use in patients on peritoneal dialysis.

Results of the study were reported during a virtual poster session at ASN Kidney Week 2020. The poster was titled Efficacy of Statin Use in Patients Undergoing Peritoneal Dialysis.

The study included 612 incident patients between January 2006 and August 2019. The primary outcome of interest was all-cause mortality and the main exposure of interest was a cumulative dose of statin. The definition of defined daily dose by the World Health Organization was used to define the cumulative statin dose. Statin users were defined as those who used a statin for at least 20 cumulative defined daily doses (cDDD) following initiation of peritoneal dialysis.

Median follow-up was 33.0 months. During the follow-up period, 20.0% (n=124) of the study cohort experienced the primary outcome. Mean age at initiation of peritoneal dialysis was 53.6 years and 53.8% were men. A total of 390 patients (63.7%) were statin users and 311 (50.8%) used a statin prior to initiation of peritoneal dialysis.

Following adjustment, there was an association between statin use (≥28 cDDD) and lower risk of all-cause mortality (hazard ratio [HR], 0.32; 95% confidence interval [CI], 0.20-0.52); this association was consistent regardless of statin use prior to peritoneal dialysis initiation.

Adjusted HRs for all-cause mortality were 0.87 (95% CI, 0.53-1.43), 0.39 (95% CI, 0.20-0.75), 0.41 (95% CI, 0.18-0.91) and 0.13 (95%, 0.06-0.26) for cDDD 28.365, cDDD 366-730, cDDD 731-1095, respectively, compared with cDDD <28. The risk reduction of statin use may be dose dependent.

“Statin use was associated with a reduced risk of all-cause mortality in incident peritoneal dialysis patients with or without statin use before dialysis,” the researchers said.

Source: Kim HW, Ryu GW, Kang S, Nam Y, Kin Bs. Efficacy of statin use in patients undergoing peritoneal dialysis. Abstract of a poster presented at the American Society of Nephrology virtual Kidney Week 2020 (PO1262), October 22, 2020.