#4326 STATIN INITIATION AND RISK OF INCIDENT KIDNEY DISEASE IN PATIENTS WITH DIABETES

Abstract

Abstract Background and Aims The role of statin therapy in the development of kidney disease in patients with type 2 diabetes mellitus (T2DM) remains uncertain. We aim to determine the relationships between statin initiation and kidney outcomes in patients with T2DM. Method Using deidentified electronic health record data and new-user design, we conducted a nationwide retrospective cohort of patients with T2DM aged 40 years or older across China. The study outcomes included the development of diabetic kidney disease (DKD) and a sustained ≥40% decline in estimated glomerular filtration rate (eGFR). Cox proportional hazards regression was used to evaluate the relationships between statin initiation and kidney outcomes Analyses were conducted using propensity overlap weighting to balance the characteristics. Results Among 7272 statin initiators and 12 586 noninitiators in the weighted cohort, statin initiation was associated with lower risks of incident DKD (hazard ratio [HR], 0.72; 95% confidence interval [CI] 0.62-0.83), new-onset eGFR <60 ml/min/1.73 m2 (HR 0.63, 95% CI 0.50-0.79), new-onset proteinuria (HR, 0.70; 95% CI 0.59-0.84) and kidney function decline (HR 0.60, 95% CI 0.44-0.81). Among statin initiators, intensive control of LDL-C (<1.8 mmol/L) had a lower risk of incident DKD (HR 0.51, 95% CI 0.32-0.81) than that in non-control group (LDL-C ≥ 3.4 mmol/L). Similar results were obtained for participants with differing patterns of dyslipidemia, those using different statins, and after stratification according to the characteristics of the participants. Conclusion Statin initiation is significantly associated with a lower risk of kidney disease development in patients with diabetes. This reno-protective effect was more prominent in patients with intensive control of LDL-C.