The Association Between Statin Use and Risk of Chronic Kidney Disease in Community-Dwelling Older People in Shanghai, China

Figures & data

Figure 1 Flowchart of study inclusion.

Table 1 Baseline Characteristics of Statin Users and Nonusers Before and After Propensity Score Matching

Characteristics	Statin Users (n=624)	Nonusers (n=1831)	Standard Difference	p	Statin Users (n=604)	Nonusers (n=604)	Standard Difference	p
Age, mean (SD), year	68.18 (2.58)	68.02 (2.68)	0.06	0.19	68.20 (2.60)	68.13 (2.61)	0.03	0.67
Male, N (%)	223 (35.74)	785 (42.87)	−0.15	<0.01	215 (35.60)	219 (36.26)	−0.01	0.81
Smoking, N (%)	69 (11.06)	310 (16.93)	−0.18	<0.01	66 (10.93)	64 (10.60)	0.01	0.85
ACEIs/ARBs, N (%)	345 (55.29)	691 (37.74)	0.36	<0.01	331 (54.80)	343 (56.79)	−0.04	0.49
CCBs, N (%)	237 (37.98)	459 (25.07)	0.28	<0.01	223 (36.92)	245 (40.56)	−0.08	0.19
Beta-blockers, N (%)	162 (25.96)	352 (19.22)	0.16	<0.01	158 (26.16)	156 (25.83)	0.01	0.90
Diuretics, N (%)	92 (14.74)	197 (10.76)	0.12	0.01	90 (14.90)	82 (13.58)	0.04	0.51
History of hypertension, N (%)	349 (55.93)	965 (52.70)	0.07	0.16	340 (56.29)	341 (56.46)	<-0.01	0.95
Antidiabetic drugs, N (%)	143 (22.92)	262 (14.31)	0.22	<0.01	136 (22.52)	139 (23.01)	−0.01	0.84
History of diabetes mellitus, N (%)	97 (15.54)	234 (12.78)	0.08	0.08	95 (15.73)	101 (16.72)	−0.03	0.64
SBP, mean (SD), mm Hg	136.19 (18.30)	135.40 (17.63)	0.04	0.34	136.06 (18.40)	135.99 (16.86)	<0.01	0.94
DBP, mean (SD), mm Hg	79.23 (8.98)	77.82 (9.53)	0.15	<0.01	79.16 (8.97)	79.62 (9.54)	−0.05	0.39
HbA1c, mean (SD), %	6.33 (0.88)	6.01 (0.84)	0.37	<0.01	6.30 (0.83)	6.31 (1.10)	−0.01	0.84
FPG, mean (SD), mmol/l	5.64 (1.11)	5.58 (1.24)	0.05	0.26	5.64 (1.11)	5.66 (1.28)	−0.02	0.75
TC, mean (SD), mmol/l	5.07 (1.05)	4.85 (0.90)	0.22	<0.01	5.05 (1.05)	5.03 (0.91)	0.02	0.79
LDL, mean (SD), mmol/l	2.93 (0.88)	2.87 (0.78)	0.08	0.09	2.93 (0.88)	2.95 (0.78)	−0.03	0.66
HDL, mean (SD), mmol/l	1.72 (0.50)	1.56 (0.45)	0.35	<0.01	1.71 (0.50)	1.68 (0.49)	0.06	0.32
TG, mean (SD), mmol/l	1.78 (1.02)	1.53 (0.83)	0.28	<0.01	1.73 (0.96)	1.73 (0.97)	0.01	0.92
WHR, mean (SD)	0.91 (0.06)	0.91 (0.06)	0.04	0.44	0.91 (0.06)	0.91 (0.06)	0.01	0.83
BMI, mean (SD), kg/m^2	24.90 (3.28)	24.77 (3.33)	0.04	0.41	24.81 (3.23)	24.71 (3.45)	0.03	0.61
AST, mean (SD)	23.99 (6.81)	22.97 (6.92)	0.15	<0.01	23.90 (6.57)	23.58 (7.49)	0.05	0.43
ALT, mean (SD)	20.93 (10.43)	18.98 (9.48)	0.20	<0.01	20.64 (10.11)	20.14 (10.87)	0.05	0.41
BUN, mean (SD), mmol/L	5.74 (0.47)	5.74 (0.47)	0.01	0.85	5.74 (0.46)	5.74 (0.48)	<0.01	0.98
TBIL, mean (SD), μmol/L	12.90 (4.98)	12.82 (5.02)	0.02	0.74	12.87 (4.94)	12.92 (4.94)	−0.01	0.85
UA, mean (SD), μmol/L	318.19 (78.32)	314.66 (79.50)	0.05	0.34	317.71 (77.82)	319.30 (82.98)	−0.02	0.73
eGFR, mean (SD), mL/min/1.73m^2	85.50 (12.29)	85.56 (11.81)	−0.01	0.90	85.26 (11.16)	84.99 (11.54)	0.02	0.68

Abbreviations: ACEIs/ARBs, angiotensin-converting-enzyme inhibitors/angiotensin receptor blockers; CCBs, calcium channel blockers; SBP, systolic blood pressure; DBP, diastolic blood pressure; HbA1c, glycated hemoglobin; FPG, fasting plasma glucose; TC, total cholesterol; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglycerides; WHR, waist-to-hip ratio; BMI, body mass index; AST, aspartate transaminase; ALT, alanine transaminase; BUN, blood urea nitrogen; TBIL, total bilirubin; UA, uric acid; eGFR, estimated glomerular filtration rate.

Table 2 Association of Statin Use with Risk of CKD Progression and Changes in eGFR

	Unmatched Cohort			Matched Cohort
	Statin Users	Nonusers	p	Statin Users	Nonusers	p
New-onset CKD
HR (95% CI)	0.73 (0.59 to 0.91)	1 (reference)	<0.01	0.75 (0.59 to 0.97)	1 (reference)	0.02
Changes in eGFR, mL/min/1.73 m^2
1 year	−4.63 (−5.58 to −3.67)	−5.50 (−6.15 to −4.84)	0.18	−4.35 (−5.26 to −3.45)	−5.15 (−6.21 to −4.10)	0.22
2 years	−6.27 (−7.20 to −5.34)	−6.97 (−7.60 to −6.34)	0.27	−6.10 (−7.04 to −5.16)	−7.10 (−8.16 to −6.03)	0.11
3 years	−7.11 (−8.10 to −6.11)	−8.54 (−9.16 to −7.92)	0.02	−7.00 (−7.93 to −5.99)	−8.30 (−9.33 to −7.27)	0.04

Notes: HR (95% CI) was estimated by Poisson generalized linear models adjusted for age, sex, smoking, ACEIs/ARBs, CCBs, beta-blockers, diuretics, history of hypertension, antidiabetic drugs, history of diabetes mellitus, SBP, DBP, HbA1c, FPG, TC, LDL, HDL, TG, WHR, BMI, AST, ALT, BUN, TBIL, UA and baseline eGFR in the unmatched cohort analyses. Changes in eGFR were estimated by linear mixed-effects models.

Abbreviations: CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HR, hazard ratio; CI, confidence interval.

Figure 2 Frequencies of new-onset CKD in three follow-up visits among statin users and nonusers in the unmatched cohort (A) and matched cohort (B).

Table 3 Association Between Dyslipidemia and Risk of CKD Progression in Statin Users and Nonusers

	Unmatched Cohort		Matched Cohort
	HR (95% CI)	p	HR (95% CI)	p
Statin users
Normal blood lipids	1 (reference)		1 (reference)
Dyslipidemia	1.61 (1.10 to 2.36)	0.01	1.54 (1.01 to 2.36)	0.04
Nonusers
Normal blood lipids	1 (reference)		1 (reference)
Dyslipidemia	1.49 (1.22 to 1.81)	<0.01	1.32 (1.05 to 1.68)	0.02

Notes: HR (95% CI) was estimated by Poisson generalized linear models adjusted for age, sex smoking, ACEIs/ARBs, CCBs, beta-blockers, diuretics, history of hypertension, antidiabetic drugs, history of diabetes mellitus, SBP, DBP, HbA1c, FPG, WHR, BMI, AST, ALT, BUN, TBIL, UA and baseline eGFR in the unmatched cohort analyses.

Abbreviations: CKD, chronic kidney disease; HR, hazard ratio; CI, confidence interval.