Association Between Preoperative Statin Exposure and Acute Kidney Injury in Adult Patients Undergoing Cardiac Surgery

Abstract

The existing literature has shown conflicting results regarding the association between preoperative statin exposure and the risk of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI). A single-center retrospective observational study. A single, large, tertiary care center. Adult patients undergoing open cardiac surgery between January 1, 2012 and January 1, 2019. AKI was defined using the Kidney Disease: Improving Global Outcomes criteria. A multivariate logistic regression analysis and propensity score-matched analysis were used to study the association. A total of 58,399 patient charts were retrospectively reviewed. The preoperative statin exposure cohort had a lower prevalence of all stages of CSA-AKI (30.7% v 36.3%, p < 0.001) and stage 3 CSA-AKI (0.9% v 2.1%, p < 0.001). After adjusting for confounding factors, preoperative statin exposure was a protective factor against all stages of postoperative CSA-AKI (odds ratio [OR], 0.885, 95% confidence interval [CI], 0.852-0.920, p < 0.001) and stage 3 CSA-AKI in adults (OR, 0.671, 95% CI, 0.567-0.795, p < 0.001). A propensity score-matched analysis showed that the preoperative statin exposure cohort had a lower risk of all stages of postoperative CSA-AKI (30.7% v 35.3%, p < 0.001) and stage 3 CSA-AKI (0.9% v 2.2%, p < 0.001) than the control cohort. Preoperative statin exposure was associated with all stages of postoperative CSA-AKI and stage 3 CSA-AKI.