Abstract P628: The Right Dose for the Right Patient - High Intensity Rosuvastatin Dosing in Patients With Chronic Kidney Disease

Abstract

Introduction: The utilization of high intensity statins for lipid lowering therapy has revolutionized our approach to decreasing the incidence of myocardial infarction. In February 2003, rosuvastatin was approved by the FDA for use at dosages ranging from 5mg to 40mg daily, with lower doses recommended for patients with reduced glomerular filtration rates (GFRs). Prescribing patterns of rosuvastatin for patients with chronic kidney disease (CKD), notably those with a GFR < 30 mL/min/1.73m 2 , is largely unstudied. Methods: A single center retrospective study of all admitted patients with a chart diagnosis of chronic kidney disease (CKD) over the course of one year was performed. Data on inpatient rosuvastatin orders and overall statin selection was collected and analyzed. Results: Between 10/1/2021-10/1/2022, a total of 5359 patients were admitted with the diagnosis of CKD. In this cohort, 62% (n = 3325) had a prescription for a statin placed for continuation of outpatient care or new initiation of lipid lowering therapy. Most patients were on atorvastatin (69.4%, n = 2310) or rosuvastatin (20.9%, n = 695). Among inpatients with CKD, a total of 1465 inpatient rosuvastatin orders were placed. Almost 32% (n = 468) of these patients had an eGFR <30 mL/min/1.73m 2 . Of this cohort, 48% (n = 223) were prescribed doses of 20mg or 40mg rosuvastatin daily, which is above the FDA recommended dose for this population ( Figure 1 ). Conclusions: A large percentage of patients on lipid lowering therapies have CKD, and data regarding renal outcomes associated with high doses of statins in this population are limited. In this large single center study, we found that nearly half of patients with eGFR <30 mL/min/1.73m 2 were on inappropriately high doses of rosuvastatin when considering their kidney function. Further research into long term outcomes and rosuvastatin dosing in this patient population is needed.