Work

Effect of Statins in Patients With Hemodialysis‐Dependent Chronic Kidney Disease: A Nationwide Cohort Study

Year: 2025

Type: article

Abstract: Background Guidelines for lipid‐lowering therapy in patients with dialysis‐dependent chronic kidney disease remain ambiguous. We aimed to explore cardiovascular outcomes associated with statin use in patients with hemodialysis‐dependent chronic kidney disease, stratified by prior statin use. Methods This was a retrospective cohort study of patients with chronic kidney disease who initiated maintenance hemodialysis, using a nationwide health claims database in Korea between 2010 and 2021. A multivariate Cox regression analysis was performed, incorporating statin use throughout the follow‐up period as a time‐dependent variable. The primary outcome was a composite of stroke, myocardial infarction, and all‐cause mortality. A subgroup analysis was conducted based on statin use before hemodialysis initiation. Results Of the 49 868 study participants, the mean age at hemodialysis initiation was 65.5±11.2 years, and 32 225 (64.6%) were men. During a mean follow‐up of 3.8 years, the primary composite outcome occurred in 20 345 patients (40.8%). Throughout the follow‐up period, approximately 40% of patients received statin therapy. Statin use was significantly associated with a reduced risk of the primary composite outcome (adjusted hazard ratio, 0.51 [95% CI, 0.49–0.53]; P <0.001). This association was consistent regardless of prior statin use, although the benefit was less pronounced in statin‐naïve patients ( P for interaction <0.001). Conclusions Statin use was consistently associated with improved long‐term cardiovascular outcomes in patients with hemodialysis‐dependent chronic kidney disease, regardless of prior statin use. These findings suggest that continuing statin therapy is crucial for cardiovascular prevention in patients already receiving statins before hemodialysis initiation; initiating statin therapy may also provide clinical benefits in statin‐naïve patients undergoing hemodialysis.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.125.043214

Authors: Minyoul Baik, Jimin Jeon, Joonsang Yoo, Jinkwon Kim

Institution: Yonsei University

Language: English

Topic: Lipoproteins and Cardiovascular Health

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,810