Statins use and the risk of acute kidney injury: a meta-analysis

Figures & data

Figure 1. Flow chart of study selection.

Table 1 Characteristics of studies evaluating the association between statins use and AKI risk.

Study	Study design	Ethnicity	Age (years)	Statins/ control (n)	Therapy	Outcome statins/control	Length of follow-up	Definition of AKI
Pan et al. (2004)18	RC	Caucasians	62.9	943/720	Cardiac surgery	59/39	30 d	NR
Subramaniam et al. (2008)16	RC	Caucasians	64.9	654/654	Cardiac surgery	8/8	NR	NR
Virani et al. (2008)17	RC	Caucasians	65	1675/1326	Cardiac surgery	42/46	NR	ATN, AIN
Fedoruk et al. (2008)25	RC	Caucasians	64.3	203/244	Cardiac surgery	8/14	30 d	Isc > twice
Jo et al. (2008)28	RCT	Asians	65.6	118/118	Contrast media	3/4	48 h	Isc ≥ 0.5 mg/dL
Huffmyer et al. (2009)26	RC	Caucasians	64	1557/1203	Cardiac surgery	436/331	NR	eGFR > 50%
Allou et al. (2010)24	RC	Caucasians	62.1	222/208	Cardiac surgery	22/29	30 d	Isc > 50%
Argalious et al. (2010)13	RC	Caucasians	67.9	6152/4487	Cardiac surgery	819/467	4 year	Isc > 0.3 mg/dL
Billings et al. (2010)12	RC	Caucasians	59.9	174/150	Cardiac surgery	39/29	NR	RIFLE
Toso et al. (2010)20	RCT	Caucasians	75.5	152/152	Contrast media	15/16	5 d	Isc > 0.5 mg/dL
Acikel et al. (2010)23	RCT	Asians	59.8	80/80	Contrast media	0/1	48 h	NR
Ozhan et al. (2010)22	RCT	Asians	54.5	60/70	Contrast media	2/7	48 h	Isc ≥ 0.5 mg/dL
Bolesta et al. (2011)21	RC	Caucasians	67.6	356/207	Cardiac surgery	125/54	48 h	Isc ≥ 0.3 mg/dL
Mithani et al. (2011)11	RC	Caucasians	66	1434/670	Cardiac surgery	322/173	48 h	Isc ≥ 0.3 mg/dL
Molnar et al. (2011)27	RC	Caucasians	73	67,941/145,406	Elective surgery	1665/2355	14 d	Isc > 0.5 mg/dL
Patti et al. (2011)19	RCT	Caucasians	65.5	120/121	Contrast media	6/16	48 h	Isc ≥ 0.5 mg/dL
Prowle et al. (2012)10	RCT	Caucasians	68	42/43	Cardiac surgery	6/7	5 d	Isc > 50%
Quintavalle et al. (2012)14	RCT	Caucasians	70	202/208	Contrast media	9/37	1 week	Isc > 10%
Murugan et al. (2012)9	PC	Caucasians	69.6	413/1423	CAP	176/455	1 year	RIFLE
Brunelli et al. (2012)15	RC	Caucasians	60.7	10,779/67,321	Elective surgery	2522/14,406	30 d	Isc ≥ 0.3 mg/dL
Layton et al. (2013)8	RC	Caucasians	52.5	3,905,155/281,7621	Cardiac surgery	36,783/9661	1 year	Isc ≥ 0.3 mg/dL

Note: AKI, acute kidney injury; PCI, percutaneous coronary intervention; CAP, community acquired pneumonia; NR, not reported; CA, coronary angiograpghy; RC, retrospective cohort; PC, prospective cohort; RCT, randomized controlled trial; d, day; w, week; y, year; Isc, increased serum creatinine; ATN, acute tubular necrosis; AIN, acute interstitial necrosis.

Table 2. Statins protocol of included studies.

Study	Status	Duration	Dose
Pan et al. (2004)18	Past use	Short-term	Low
Subramaniam et al. (2008)16	Past use	Long-term	Low
Virani et al. (2008)17	Past use	Short-term	Low
Fedoruk et al. (2008)25	Past use	Long-term	Low
Jo et al. (2008)28	Current use	Short-term	Low
Huffmyer et al. (2009)26	Past use	Short-term	Low
Allou et al. (2010)24	Past use	Long-term	Low
Argalious et al. (2010)13	Past use	Long-term	Low
Billings et al. (2010)12	Past use	Long-term	Low
Toso et al. (2010)20	Current use	Short-term	High
Acikel et al. (2010)23	Current use	Short-term	Low
Ozhan et al. (2010)22	Current use	Short-term	High
Bolesta et al. (2011)21	Past use	Short-term	Low
Mithani et al. (2011)11	Past use	Short-term	Low
Molnar et al. (2011)27	Past use	Long-term	Low
Patti et al. (2011)19	Current use	Short-term	High
Prowle et al. (2012)10	Current use	Short-term	Low
Quintavalle et al. (2012)14	Current use	Short-term	Low
Murugan et al. (2012)9	Current use	Short-term	High
Brunelli et al. (2012)15	Past use	Long-term	High
Layton et al. (2013)8	Past use	Long-term	High

Figure 2. Association between statins use and AKI risk in Caucasians, Asians, and overall populations.

Figure 3. Association between statins use and AKI risk based on different therapies.

Figure 4. Association between statins use and AKI risk based on different study types.

Table 3. Characteristics of univariate meta-regression analysis.

Covariate	Co-efficient	95% CI	p
Age	0.022	−0.692 to 0.649	0.947
Length of follow-up	0.002	−0.043 to 0.047	0.924

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