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Statin use low in patients with chronic kidney disease

SAN DIEGO — While the use of statins has increased over time, few patients with chronic kidney disease use the medication, according to research presented at ASN Kidney Week.

“Cardiovascular disease is a significant issue in chronic kidney disease (CKD),” Daniel Murphy, MD, renal fellow at the University of Minnesota, told Healio Internal Medicine. “Though many of those who have CKD have other reasons to be on statin therapy, there is evidence that statins benefit those with CKD generally. Prior work has looked at how those with CKD may benefit from previous and potential changes in the guideline recommendations for statin prescribing.”

“In light of this, we wanted to describe the current state of statin use in the United States CKD population, including if any disparities or trends over time existed,” he added.

Murphy and colleagues analyzed data from the National Health and Nutrition Examination Survey for trends in statin use among adults between 1999 and 2014. They included adults with creatinine-based estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73 m² or albumin-creatinine ratio of 30 mg/g or more.

The researchers found that statins were used by 28.9% of participants with CKD. Statin use increased during the study period from 17.1% in 1999-2002 to 35.6% in 2011-2014. After 2012, statin use may have begun to plateau, according to Murphy.

Patients with albuminuria were more likely to use statins (23.6% vs. 12.2%). Patients with a reduced eGFR of less than 60 ml/min/1.73 m² had a greater likelihood of statin use compared with those with a preserved eGFR (41.4% vs. 11.4%).

There were lower odds of receiving statins among participants of Hispanic race/ethnicity with CKD (15.4%), compared with whites (32%), blacks (26.2%) and other races/ethnicities (24.6%). Males with CKD more commonly used statins than females (32.4% vs. 26.3%).

The odds ratio of statin use adjusted for age, sex and race/ethnicity was 1.77 (95% CI, 1.44-2.17) for 2003-2006, 2.51 (95% CI, 2.04-3.08) for 2007-2010 and 2.94 (95% CI, 2.34-3.70) for 2011-2014, compared with 1999-2002. The adjusted odds ratio of statin use was 0.62 (95% CI, 0.5-0.78) for Hispanics vs. whites.

Statin use was also associated with older age, male sex, BMI of 30 kg/m² or more, diabetes mellitus, hypertension, myocardial infarction, heart failure and stroke.

“We encourage physicians, including both primary care providers and nephrologists, to evaluate whether their patients with CKD are on statin therapy and, if not, to consider potential treatment with a statin,” Murphy said. – by Alaina Tedesco

Reference:

Murphy DP, Foley RN. Abstract: TH-PO1047. Presented at: ASN Kidney Week; Oct. 23-28, 2018; San Diego.

Disclosure: Murphy reports no relevant financial disclosures.