Effect of statin on life prognosis in Japanese patients undergoing hemodialysis


Autoři: Yuki Ota aff001;  Mineaki Kitamura aff001;  Kumiko Muta aff001;  Hiroshi Yamashita aff001;  Tadashi Uramatsu aff001;  Yoko Obata aff001;  Takashi Harada aff003;  Satoshi Funakoshi aff003;  Hiroshi Mukae aff004;  Tomoya Nishino aff001
Působiště autorů: Department of Nephrology, Nagasaki University Hospital, Nagasaki, Japan aff001;  Division of Blood Purification, Nagasaki University Hospital, Nagasaki, Japan aff002;  Department of Nephrology, Nagasaki Renal Center, Nagasaki, Japan aff003;  Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224111

Souhrn

The effect of statin on hemodialysis patients is controversial. Although previous large-scale studies did not clarify its effect in this population, recent studies suggest that statins could be useful in reducing the risk of cardiovascular events and all-cause mortality in specific groups of patients undergoing hemodialysis. The aforementioned large-scale studies included a small percentage of Asians, and few studies have investigated the effects of statins in Asians undergoing hemodialysis. Thus, we investigated the benefits of statins in patients undergoing maintenance hemodialysis at a single center in Japan. We obtained demographic, clinical, and hemodialysis data of all patients who underwent maintenance hemodialysis at the Nagasaki Renal Center between July 2011 and June 2012. Patients were followed-up until June 2018. We studied 339 patients, of which 51 (15.0%) were prescribed pitavastatin. The mean observation period was 4.1±2.3 years, 43% were women, and the median hemodialysis vintage at baseline was 4.7 years. During the follow-up, 198 patients (58%) died, of which 22 (43%) were prescribed pitavastatin and 176 (61%) were not prescribed any statins. After propensity score matching based on age, sex, dialysis vintage, dialysis time, diabetes mellitus, ischemic heart disease, dry weight, left ventricular ejection fraction, and serum albumin, an intergroup comparison between those who received statins and those who did not (44 patients in each group) showed significant differences in survival rate based on the log-rank test (P<0.05). Although the causes of death did not differ significantly between groups, deaths due to cardiovascular events, infections, and cancer were fewer in the group prescribed statins. Our results suggest that statins may reduce mortality in Japanese patients undergoing maintenance hemodialysis. Although potential residual confounders exist, statins may have an influence on the reduction in the incidence of cardiovascular events, infections, and cancer. Nevertheless, further studies are required to prove this hypothesis.

Klíčová slova:

Coronary heart disease – Diabetes mellitus – Ejection fraction – Cholesterol – Infarction – Medical dialysis – Serum albumin – Statins


Zdroje

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PLOS One


2019 Číslo 10