High-Dose Statins May Increase Acute Kidney Injury, Drug Used to Lower Cholesterol and Reduce Risk for Cardiovascular Disease

A new study indicates that there is a drug used to lower cholesterol can increase the risk of hospitalization for acute kidney injury.

The high potenty of statins, a widely-used class of drug used as a way to reduce the risk of cardiovascular disease. Lead researcher Colin Dormuth of the University of British Columbia in Vancouver, Canada, and colleagues, wrote about their findings in a BMJ paper published this month.

Largely as a result of clinical trials showing improved cardiovascular outcomes, there has been a trend toward increasing the potency of statins, either with larger doses, such as simvastatin or atorvastatin 40-80 mg, or with the more potent form, rosuvastatin.

But researchers are beginning to suggest that increasing potency may lead to adverse kidney problems, and because statins are so widely used, concerns are being raised about these adverse events.

Clinical trials don't involve large numbers of people, so adverse side effects may not be common enough to be identified, and it is only in postmarketing monitoring, and analyses of large groups of patients, that they begin to show.

Researchers from across Canada compared patients who were prescribed high potency statins in their latest study to those who were prescribed low potency statins in seven Canadian provinces and two international databases (UK and US) between 1997 and 2008.

They then reviewed the health records of 2 million people from the Canadian Network for Observational Drug Effect Studies (CNODES) to assess the link between treatment with high versus low potency statins and hospitalization for acute kidney injury in patients with and without chronic kidney disease, looking at patients who were age 40 and over: the average age was 68.

High potency was defined as rosuvastatin at doses of 10mg or higher, atorvastatin at doses of 20mg or higher, and simvastatin at doses of 40mg or higher. All others were defined as low potency.

When they analyzed the data, the researchers found that high potency statin users were 34 percent more likely to be hospitalized for acute kidney injury compared with low potency statin users in the first 120 days of treatment.

And the risk remained higher for two years after starting treatment.

However, rates were not significantly increased in patients with chronic kidney disease.