ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1639130
Statin Use and Acute Kidney Injury among Hospitalized Chronic Kidney Disease Patients: A Retrospective Cohort Study
Provisionally accepted
- 1First Hospital, Peking University, Beijing, China
- 2Peking University, Beijing, China
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Background: Chronic kidney disease (CKD) constitutes a substantial burden in terms of cardiovascular disease and acute kidney injury (AKI). While statins are recommended for their cardiovascular benefits in CKD patients, their impact on AKI remains inconclusive. Methods: A retrospective screening was conducted on all adult hospital admissions from January 1, 2018, to December 31, 2020, including patients with CKD. Statin exposure was defined as any prescription within 48 hours of admission. Patients were monitored until death, discharge, or a maximum of 30 days. The primary outcome was in-hospital AKI, with in-hospital mortality as the secondary outcome. Results: In a cohort of 5,376 patients, the median age was 72 years; 3,184 (59.2%) were male, and 2,129 (39.6%) were statin users. In-hospital AKI was observed in 149 (7.0%) of statin users compared to 213 (6.6%) of non-users. Statin use was significantly associated with a reduced risk of in-hospital AKI (adjusted hazard ratio [aHR], 0.74; 95% confidence interval [CI], 0.56-0.96) and in-hospital mortality (aHR, 0.45; 95% CI, 0.24-0.88). These outcomes were consistent across subgroup analyses stratified by age, gender, baseline estimated glomerular filtration rate (eGFR), and cardiovascular disease (all P for interaction >0.05), as well as in sensitivity analyses excluding patients who discontinued statin therapy during hospitalization or initiated statin therapy postbaseline. Among atorvastatin users (63.4%, 1350/2129), only medium-dose atorvastatin was significantly associated with reduced risk of in-hospital AKI after full adjustment (aHR, 0.68; 95% CI, 0.49-0.95). Conclusions: Statin use may improve survival and reduced AKI risk in hospitalized patients with CKD, with atorvastatin showing particularly favorable renoprotective effects.
Keywords: Acute Kidney Injury, statin, Chronic Kidney Disease, Mortality, atorvastatin
Received: 01 Jun 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Tang, Xu, Xu, Zhao, Zhu, Lv, Yang and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xi-Zi Zheng, First Hospital, Peking University, Beijing, China
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