Introduction:
Statins frequently lead to various adverse drug reactions (ADRs). Main ADRs are myalgia and myopathy, new-onset diabetes mellitus (NODM), drug-induced liver injury (DILI) and kidney injury. Statin-related events are commonly reported and often lead to statin discontinuation. The importance of identifying preferred statin for a patient with individual comorbidities determines clinicians need to have better information on ADRs, while ADRs of some statins are different.
The aim of this study was to analyze the difference ADRs signal between difference types of statins (atorvastatin, fluvastatin, rosuvastatin and simvastatin) on kidney injury in a Croatian population managed at a tertiary care center in Clinical Hospital Merkur, Zagreb.
Methods:
This was a retrospective single-center study. Data was collected from the hospital informatics system on patients with statins ADRs reports in a tertiary care center. Patient data obtained between the January of 2018 to the January of 2023 was included. In order to be included into the study, patients needed to have available data on laboratory parameters and statins ADRs report. Patients without data were excluded from the study. Data was analyzed using the JASP open-source statistical software. Statistical significance was set at a threshold of p < 0.05.
Results:
Acute kidney injury or chronic kidney disease were analysed in group with ADRs and without ADRs. Our analysis showed that the risks of renal disorders were significantly different amongst the 4 statins in ADRs groups (χ 2 test, P <0.001). The distribution of age (46-89 y) and gender (M 31%/F 69%) was similar between the 4 statins ADRs groups. Patients with ADRs have significantly higher mean arterial pressures (calculated as 0.66*diastolic blood pressure + 0.33*systolic blood pressure) (110 mmHg vs 95.7 mmHg, p = 0.016), higher serum creatinine concentrations (98.5 umol/L vs 74 umol/L, p < 0.001) and had a significantly higher number of antihypertensive medications in their therapy (5 vs 3 different types of medications, p < 0.001) in comparations with non ADRs. There were no significant differences between other measured parameters (serum electrolytes and body mass index). The group with atorvastatin ADRs had acute kidney injury in 9.03%, group with fluvastatin ADRs in 12.13%, rosuvastatin ADRs in 9.40% and simvastatin in 9.88%. Rosuvastatin (80 mg daily) was associated with persistent proteinuria and hematuria (0.7% at 40 mg dosage and approximately 3% at 80 mg). Chronic kidney disease appeared to be more strongger associated with the use of fluvastatin (3 times higer than the use of atorvastatin or rosuvastatin) and simvastatin (2 times higer than the use of atorvastatin or rosuvastatin).
Conclusions:
In this retrospective single-center study, the results of testing reveal that fluvastatin had higher rates of renal disorders (12.13%). Acute kidney injury was less reported amongst the patients taking atorvastatin compared with the patients on fluvastatin and simvastatin. All 4 statins had high risks of chronic kidney disease. appeared to be more strongly associated with the use of fluvastatin and simvastatin than the other statins (atorvastatin or rosuvastatin).
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.