Effects of statins on the incidence and outcomes of acute kidney injury in critically ill patients: a systematic review and meta-analysis

被引：19

作者：

Vahedian-Azimi, Amir ^{[1
]}

Beni, Farshad Heidari ^{[2
,11
]}

Fras, Zlatko ^{[3
]}

Banach, Maciej ^{[4
]}

Mohammadi, Seyede Momeneh ^{[5
]}

Jamialahmadi, Tannaz ^{[6
]}

Sahebkar, Amirhossein ^{[7
,8
,9
,10
]}

机构：

[1] Baqiyatallah Univ Med Sci, Nursing Fac, Trauma Res Ctr, Tehran, Iran

[2] Iran Univ Med Sci, Nursing Care Res Ctr NCRC, Sch Nursing & Midwifery, Tehran, Iran

[3] Univ Med Ctr Ljubljana, Univ Ljubljana, Med Fac, Ctr Prevent Cardiol, Ljubljana, Slovenia

[4] Med Univ Lodz MUL, Dept Prevent Cardiol & Lipidol, Lodz, Poland

[5] Zanjan Univ Med Sci, Fac Med, Dept Anat Sci, Zanjan, Iran

[6] Mashhad Univ Med Sci, Int UNESCO Ctr Hlth Related Basic Sci & Human Nutr, Mashhad, Iran

[7] Mashhad Univ Med Sci, Pharmaceut Technol Inst, Biotechnol Res Ctr, Mashhad, Iran

[8] Mashhad Univ Med Sci, Appl Biomed Res Ctr, Mashhad, Iran

[9] Mashhad Univ Med Sci, Sch Pharm, Mashhad, Iran

[10] Mashhad Univ Med Sci, Dept Biotechnol, Sch Pharm, POB 91779-48564, Mashhad, Iran

[11] Iran Univ Med Sci, Nursing Care Res Ctr NCRC, Sch Nursing & Midwifery, Tehran, Iran

来源：

ARCHIVES OF MEDICAL SCIENCE | 2023年 / 19卷 / 04期

关键词：

acute kidney injury; statins; surgery; intensive care unit; mortality; ISCHEMIA-REPERFUSION INJURY; ACUTE-RENAL-FAILURE; CARDIAC-SURGERY; REDUCTASE INHIBITORS; VASCULAR-SURGERY; THERAPY; ATORVASTATIN; ROSUVASTATIN; MORTALITY; EFFICACY;

D O I：

10.5114/aoms/159992

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: In critically ill patients, acute kidney injury (AKI) is a common complication with very high mortality rates. Several studies indicated that statin therapy, primarily due to its so-called pleiotropic effects, may beneficially affect the course of the disease, otherwise leading to significant clinical complications. However, both the original research as well as available meta-analyses on these associations report equivocal results. This leaves open a question whether pre-and perioperative statins might prevent AKI and improve overall prognosis in patients undergoing surgery.Material and methods: Following a systematic search of the literature, we performed a meta-analysis of selected clinical studies investigating the impact of statin treatment on the development and the clinical outcomes of AKI among subjects undergoing surgeries. The pooled odds ratios (OR) with 95% confidence intervals (CI) for the development of AKI and AKI-associated mortality, as well as the pooled mean differences (MD) and 95% CI for mean intensive care unit (ICU) stay and overall hospital length of stay were calculated for statin users compared to non-users.Results: Our results showed a highly significant association between statin use and the decrease in mortality of patients with AKI (OR = 0.73, 95% CI: 0.69-0.77; p<0.001). The development of AKI (OR = 0.92, 95% CI: 0.63- 1.33; p = 0.659) as well as the ICU stay (MD = -0.02, 95% CI: -0.06 - 0.02; p = 0.321) were not significantly affected, while the overall hospital length of stay (MD = -0.49, 95% CI: -0.91 -0.07; p = 0.020) was reduced. Subgroup analysis showed that both pre-and postoperative statin use were not associated with the risk of AKI.Conclusions: Our analysis showed a significant association between statin therapy and overall mortality of critically ill surgical patients diagnosed with AKI, while at the same time the use of statins did not affect the length of their stay in ICU.

引用

页码：952 / 964

页数：13