The Effect of Statins on Mortality of Patients With Chronic Kidney Disease Based on Data of the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) and Korea National Health Insurance Claims Database.

Ji Eun Kim,Young Joo Kwon,Won Yong Cho,Gang-Jee Ko,Myung Gyu Kim,Yun Jin Choi,Sang Kyung Jo,Se Won Oh,Shin Young Ahn

doi:10.3389/fneph.2021.821585

Abstract

The role of statins in chronic kidney disease (CKD) has been extensively evaluated, but it remains controversial in specific population such as dialysis-dependent CKD. This study examined the effect of statins on mortality in CKD patients using two large databases. In data from the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM) from two hospitals, CKD was defined as an estimated glomerular filtration rate < 60 mL/min/m2; we compared survival between patients with or without statin treatment. As a sensitivity analysis, the results were validated with the Korea National Health Insurance (KNHI) claims database. In the analysis of CDM datasets, statin users showed significantly lower risks of all-cause and cardiovascular mortality in both hospitals, compared to non-users. Similar results were observed in CKD patients from the KNHI claims database. Lower mortality in the statin group was consistently evident in all subgroup analyses, including patients on dialysis and low-risk young patients. In conclusion, we found that statins were associated with lower mortality in CKD patients, regardless of dialysis status or other risk factors.

Highlights

Chronic kidney disease (CKD) is an emerging global health issue, which has increased in prevalence along with metabolic diseases such as diabetes and hypertension [1]
Statins block the conversion of b-hydroxy b-methylglutaryl-CoA to mevalonate during cholesterol synthesis in hepatocytes; they increase the number of low-density lipoprotein (LDL) receptors on the cell surface to reduce serum LDL cholesterol, with an excellent lipid-lowering effect [6]
We examined the protective effect of statins with data from two hospitals using a common data model, confirmed the findings using a national claims database; we aimed to establish in-depth and concrete evidence for the cardiovascular effects of statins in CKD patients

Summary

Introduction

Chronic kidney disease (CKD) is an emerging global health issue, which has increased in prevalence along with metabolic diseases such as diabetes and hypertension [1]. The incidence of cardiovascular disease (CVD) is 1.4–3.4-fold greater in CKD patients than in the general population [3]; the prevalences of dyslipidemia and atherosclerosis, which are major risk factors for CVD, are greater in CKD patients [4]. The management of these risk factors for CVD in CKD patients is essential; lifestyle changes and the use of statins (i.e., first-line treatment for hyperlipidemia in the general population) are recommended [5]. We examined the protective effect of statins with data from two hospitals using a common data model, confirmed the findings using a national claims database; we aimed to establish in-depth and concrete evidence for the cardiovascular effects of statins in CKD patients

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Results

Conclusion