Preventive effects of different doses of atorvastatin on contrast-induced acute kidney injury in patients after multiple CT perfusions

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The purpose of this clinical trial was to evaluate the preventive effects of different doses of atorvastatin on CI-AKI in patients after CT perfusions. 688 patients undergoing CT perfusions were administered doses of atorvastatin (20 mg/day, n = 164), atorvastatin (40 mg/day, n = 178), atorvastatin (60 mg/day, n = 176) and placebo (40 mg/day, n = 170). Several factors, urinary neutrophil gelatinase-associated lipocalin (NGAL) levels, protein kinase C (PKC), nuclear factor erythroid-2 related factor 2 (Nrf2), nicotinamide adenine dinucleotide phosphate (NADPH) responsible for contrast-induced acute kidney necrosis were recorded in this study. Postoperative administration of atorvastatin decreased the risk of CI-AKI and improved renal function. 60 mg/day of atorvastatin showed best preventive effect on CI-AKI in three groups determined by Charlson Cormobidity Index (CCI) and risk, injury, failure, loss, end-stage renal disease (RIFLE). 60 mg/day of atorvastatin significantly decreased the inflammatory cytokines interleukin (IL)-1β, transforming growth factor (TGF)-β, and tumor necrosis factor (TNF)-α compared to 20 mg/day and 40 mg/day of atorvastatin in patients after multiple CT perfusions. NADPH oxidase 4 (NOX4) and p22phox expression was reduced by atorvastatin treatment. In conclusion, these outcomes indicate that 60 mg/day of atorvastatin treatment reduces the risk of CI-AKI in patients after multiple CT perfusions.