HMG-CoA reductase inhibitors in kidney transplant recipients receiving tacrolimus: statins not associated with improved patient or graft survival

BMC Nephrology

Research Article

Mark Unruh¹  Nizar Younas¹  James Johnston¹  Christine M Wu¹  Jerry McCauley²  Cynthia Smetanka³  Amit Basu³  Henkie Tan³  Ron Shapiro³  Heidi Schaefer⁴  Wolfgang C Winkelmayer⁵ 

[1] Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, PA, USA;Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, PA, USA;Department of Surgery, Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA;Department of Surgery, Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA;Division of Nephrology and Hypertension, Vanderbilt University, Nashville, Tennessee, USA;Division of Nephrology, Stanford University School of Medicine Palo Alto, CA, USA;

关键词: Tacrolimus;    Propensity Score;    Kidney Transplant;    Graft Survival;    Major Adverse Cardiac Event;   

DOI  :  10.1186/1471-2369-11-5

 received in 2009-07-31, accepted in 2010-04-01,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe beneficial effects of early statin use in kidney transplant recipients, especially those on tacrolimus-based immunosuppression, are not well established. We evaluated the predictors of statin use following kidney transplantation and examined its association with patient and allograft survival.MethodsWe examined 615 consecutive patients who underwent kidney transplant at our institution between January 1998 and January 2002. Statin use was assessed at baseline and 3, 6, 9, and 12 months following kidney transplant. Patients were followed for allograft and patient survival.Results36% of the 615 kidney transplant recipients were treated with statin treatment. Statin use increased over the course of the study period. Older age, elevated body mass index, higher triglyceride levels, hypercholesterolemia, diabetes, history of myocardial infarction were associated with higher rates of statin use; elevated alkaline phosphatase levels and CMV IgG seropositivity were associated with less statin use. Older age, elevated BMI and hypercholesterolemia remained significant predictors of increased statin use after accounting for covariates using multiple regression. The early use of statins was not associated with improvements in unadjusted patient survival [HR 0.99; 95%CI 0.72-1.37] or graft survival [HR 0.97; 95% CI 0.76-1.24]. The risks of death and graft survival were not consistently reduced with exposure to statin using either adjusted models or propensity scores in Cox Proportional Hazards models.ConclusionsIn a kidney transplant population primarily receiving tacrolimus-based immunosuppression, early statin use was not associated with significantly improved graft or patient survival.

【 授权许可】

Unknown   
© Younas et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.