Shreyas S Joshi, Karen Ruth, Marc C Smaldone, David Y T Chen, Richard E Greenberg, Rosalia Viterbo, Alexander Kutikov, Robert G Uzzo
{"title":"Perioperative Statin Use and Acute Kidney Injury in Patients Undergoing Partial Nephrectomy.","authors":"Shreyas S Joshi, Karen Ruth, Marc C Smaldone, David Y T Chen, Richard E Greenberg, Rosalia Viterbo, Alexander Kutikov, Robert G Uzzo","doi":"10.3233/KCA-180031","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Statin use is widespread among the general population. Data suggest a potentially beneficial effect of statin therapy on renal function following surgery. The impact of statins on post-partial nephrectomy (PN) renal function is unknown. We hypothesized that perioperative statin use may be associated with reduced rates of acute kidney injury (AKI) in patients undergoing PN.</p><p><strong>Objectives: </strong>To evaluate the effect of perioperative statin use on AKI rates in patients undergoing PN.</p><p><strong>Materials & methods: </strong>1,056 patients undergoing PN were identified from a prospectively-maintained institutional renal mass database. Exclusion criteria included lack of preoperative serum creatinine (Cr), concurrent surgeries, and those with baseline Cr <0.4. The binary outcome was AKI, defined using modified Kidney Disease Improving Global Outcomes (KDIGO) criteria. Chi-Square and Cochran-Armitage trend tests were used to evaluate the strength of associations. A multivariate logistic regression model was used to determine predictors of AKI.</p><p><strong>Results: </strong>Statin use was reported by <i>n</i> = 346 (32.8%) patients at the time of surgery. Univariate analysis demonstrated that statin use was associated with an increased risk of AKI following PN (OR 1.38, CI 1.01-1.88, <i>p</i> = 0.04). On multivariate analysis, statin use was no longer associated with AKI following PN (OR 1.09, CI 0.76-1.56, <i>p</i> = 0.65). Gender, BMI, comorbidity index, hypertension, surgical approach, ischemia temperature/time, and nephrometry \"R\" score were all independently associated with AKI.</p><p><strong>Conclusions: </strong>Perioperative statin use at the time of PN was not associated with rates of post-operative AKI. Prospective studies are needed to elucidate the effects of statins on functional outcomes following PN.</p>","PeriodicalId":74039,"journal":{"name":"Kidney cancer (Clifton, Va.)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2018-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/83/kca-2-kca180031.PMC6364048.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney cancer (Clifton, Va.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3233/KCA-180031","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Statin use is widespread among the general population. Data suggest a potentially beneficial effect of statin therapy on renal function following surgery. The impact of statins on post-partial nephrectomy (PN) renal function is unknown. We hypothesized that perioperative statin use may be associated with reduced rates of acute kidney injury (AKI) in patients undergoing PN.
Objectives: To evaluate the effect of perioperative statin use on AKI rates in patients undergoing PN.
Materials & methods: 1,056 patients undergoing PN were identified from a prospectively-maintained institutional renal mass database. Exclusion criteria included lack of preoperative serum creatinine (Cr), concurrent surgeries, and those with baseline Cr <0.4. The binary outcome was AKI, defined using modified Kidney Disease Improving Global Outcomes (KDIGO) criteria. Chi-Square and Cochran-Armitage trend tests were used to evaluate the strength of associations. A multivariate logistic regression model was used to determine predictors of AKI.
Results: Statin use was reported by n = 346 (32.8%) patients at the time of surgery. Univariate analysis demonstrated that statin use was associated with an increased risk of AKI following PN (OR 1.38, CI 1.01-1.88, p = 0.04). On multivariate analysis, statin use was no longer associated with AKI following PN (OR 1.09, CI 0.76-1.56, p = 0.65). Gender, BMI, comorbidity index, hypertension, surgical approach, ischemia temperature/time, and nephrometry "R" score were all independently associated with AKI.
Conclusions: Perioperative statin use at the time of PN was not associated with rates of post-operative AKI. Prospective studies are needed to elucidate the effects of statins on functional outcomes following PN.