December 29, 2015

Statins May Increase Kidney Disease

This should make everyone take notice. Long-term statin use may increase kidney disease. While we are all familiar with statins increasing the risk of type 2 diabetes, this is somewhat of a surprise, but seems logical. Many of the drugs of today have more and more side effects and many can cause harms to patients.

Considering that statins have no proven cardiovascular disease prevention or life lengthening effects, it seems that the statins all have more harm causing properties than health improving properties.

In a December 1, 2015 issue of the American Journal of Cardiology, lead author Dr, Tushar Acharya of the University of California, San Francisco, said an 8-year retrospective study with a median 6.4 year follow-up associated long-term statin use with an increased risk of kidney disease. Statin users, compared with case-matched controls that didn't use statins, showed a 30% to 36% greater prevalence of kidney disease during follow-up.

Senior author Dr. Ishak A Mansi, University of Texas Southwestern, Dallas, said, “Patients who are taking statins should not stop taking them based on this study. Our study did not examine whether the benefits outweigh the risk, as it was not designed for that. Still, this study shows that despite the use of statins for more than a quarter of a century, there are aspects about its long-term effects in noncardiac diseases that we do not know very well. We are missing more extensive, real-world data of the effectiveness of statins on total morbidity and all-cause mortality, and we need further studies specifically focusing on long-term outcomes in primary prevention."

Dr. Mansi continued, “The new [ACC] guidelines . . . are projected to increase statin use to many more hundreds of millions of healthy people, and before we do that we better make sure that we are not causing harm. Our paper says to scientists, physicians, funding agencies, [and] policy makers: 'Watch out, [it] seems that we still do not know enough about the long-term effects of these drugs on [the] overall well-being of patients.'"

The overall cohort comprised 43,438 individuals: 13,626 statin users and 29,812 nonusers. The most commonly prescribed statin was simvastatin (73.5%), followed by atorvastatin (17.4%), pravastatin (7%), and rosuvastatin (Crestor, AstraZeneca) (1.7%); 38% of the statin users received high-intensity doses. The statin users took the drugs for a mean of 4.65 years.

The researchers matched 6342 statin users in the overall cohort with 6342 nonusers, according to baseline demographics, comorbidities, and presence of renal disease, healthcare utilization, and medication use. In this matched cohort, patients had a mean age of 56, and 45% were women.

"The findings of this study, though cautionary, suggest that short-term [randomized controlled trial] may not fully describe long-term adverse effects of statins," Acharya and colleagues conclude. Statins lower the risk of cardiovascular disease and cardiovascular death, but "on the other hand, statins increase the risk of incident diabetes and possibly kidney diseases, both of which paradoxically increase long-term morbidity and mortality," they continue.

No comments: