#3560 STATIN THERAPY IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HAEMODIALYSIS
Authors: Strapcane Santa , Petersons Aivars , Skride Andris , Kigitoviča Dana 
Published: June 2023

Abstract

Background and Aims
In 2017, around 4 million people with end-stage renal disease worldwide were on renal replacement therapy. Haemodialysis is accounted as the most common therapy, accounting for 69% of all renal replacement therapies and 89% of all dialysis. Patients receiving haemodialysis present significantly higher risk for cardiovascular events which affect more than two-thirds of patients, making it the primary cause of morbidity (Bello et al., 2022). Statin therapy is used as primary prevention of cardiovascular risk amongst the general population; nonetheless, in patients with chronic kidney disease the benefits of statins are controversial (Fellström et al., 2009). The aim of this study is to analyze data of statins use in patients from different Latvian haemodialysis centers.

Method
A cross-sectional observational study included consecutive patients from four haemodialysis centers from June till October 2022. Patients were interviewed about disease anamnesis, comorbidities, statins and other drug use. Data was analyzed with SPSS statistics.

Results
Among 113 included patients, 64.6% were man, mean age was 62.8±14.9 years, mean body-mass index was 26.66± 5.3 kg/m². Current smokers were 14.2%. Most common primary cause for hemodialysis (47.2%) was glomerular diseases. Comorbidities as primary arterial hypertension and diabetes were diagnosed in 39.8% and 17.7% of patients, respectively. History of arterial vascular disease was present in 47 (41.6%) patients, 26 (23%) patients underwent revascularization. Anamnesis of kidney transplantation was present in 17.7%. Mean plasma concentration for total cholesterol, LDL cholesterol and triglycerides were 4.4±1.3 mmol/L, 2.5±1.1 mmol/L and 1.7±1.3 mmol/L, respectively. Mean haemodyalisis period was 51.88 months and mean statin use period was 73.3 months. Statins were used in 60 (53.1%) patients, majority of them (68.3%) were using atorvastatin and 19 (31.7%) patients were using rosuvastatin. The most common type and dosage was atorvastatin 20 mg in 21 (35%) patient, following by atorvastatin 40mg in 9 (15%) and rosuvastatin 20mg in 9 (15%) patients. Majority of statin users (49.2%) had unknown therapy starting date regarding haemodialysis, while 31.7% of patients were using statins before haemodialysis and only 19% of patients started statin therapy while undergoing haemodialysis.
Patients who had transplantation were associated with 2.4 times increased usage of statins (P = .09). No significant lipid concentration difference was observed between patients who underwent transplantation and those who did not (p&gt;0.05). LDL concentration with and without statin use was 1.97 and 2.73 (P = .03), respectively.
Patients with history of cardiovascular events had 8.4 times higher probability of using statins than patients without cardiovascular events (p&lt;0.001, Cl 3.47-20.53) and 10.3 times higher probability of using statins after revascularization than patients without revascularization (p&lt;0.001, Cl 2.98-37.11).

Conclusion
Statin therapy was related to history of cardiovascular events and revascularization, as well expressing significantly lower LDL concentration, that might be beneficial in secondary prophylaxis. History of transplantation was associated with increased statin administration.