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Study finds low statin use among patients with CKD despite high risk for CVD
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Results of a study on patients with CKD showed fewer than 22% were prescribed statins to help reduce the risk of cardiovascular disease.
The study by researchers from Loyola Medicine, Loyola University Chicago and Hines VA Hospital was published in Clinical Kidney Journal.
“Our findings suggest a need for education efforts to increase statin use in adults with non-dialysis-dependent chronic kidney disease,” Talar Markossian, PhD, MPH, corresponding author Holly Kramer, MD, MPH, and colleagues in a Loyola University Health System, said in a press release about the study.
In the study, researchers examined the records of 581,344 patients who received care from Veterans Affairs facilities from 2012 to 2013. Patients were aged 50 years or older with stage 3 to stage 5 kidney disease but with no previous experience with dialysis or a kidney transplant.
“Data from randomized trials among individuals with nondialysis-dependent CKD have shown that statins reduce the risk for atherosclerotic cardiovascular disease (ASCVD). In fact, only blood pressure reduction and use of statin medications have been shown to reduce ASCVD risk in adults with CKD, yet few studies have examined factors associated with statin utilization in this population,” the authors wrote.
Researchers looked at statin use by CKD stage and by diagnosis of ASCVD, diabetes and hyperlipidemia.
“Statin use was the lowest in veterans without a diagnosis of ASCVD, diabetes or hyperlipidemia (21.8%), while the highest use was noted in those with a diagnosis of ASCVD (76.9%) or diabetes (75.5%) (P<.001),” the authors wrote. Compared with CKD stage 3A, which is earlier in the progression of CKD stages, odds of statin use were slightly higher among veterans with CKD stage 3B and stage 4, whereas odds of statin use were lower among veterans with stage 5 CKD.
“Odds of statin use were approximately five-fold higher among veterans with a diagnosis of hyperlipidemia (95% CI 5.03–5.22), seven-fold higher among veterans with a diagnosis of diabetes (95% CI 7.51–7.83) and 10-fold higher with a diagnosis of ASCVD (95% CI 10.42–10.83) compared with the absence of hyperlipidemia, diabetes or ASCVD diagnoses, respectively,” the authors wrote.
Of veterans with CKD, 62.1% used statins in 2012 and 55.4% used statins continuously for 2 years (2012 to 2013).
Results of a study on patients with CKD showed fewer than 22% were prescribed statins to help reduce the risk of cardiovascular disease.
“Statin use in 2012 was 76.2% and 75.5% among veterans with CKD and ASCVD or diabetes, respectively, but in the absence of ASCVD, diabetes or a diagnosis of hyperlipidemia, statin use was 21.8% (P<.001). The 10-year predicted ASCVD risk was [greater than or equal to] 7.5% in 95.1% of veterans with CKD, regardless of diabetes status,” the authors wrote.
About 90% of patients with CKD have at least a 10% risk of developing cardiovascular disease in the next 10 years, “and this risk could be reduced by taking statins,” the authors contended. “Our findings suggest a need for education efforts to increase statin use in adults with non-dialysis-dependent CKD.” – by Mark E. Neumann
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Disclosures: This work was funded in part by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development HSR&D project IIR 07-165-2. The authors report no relevant financial disclosures.
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