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High potency statins ‘linked with increased risk of acute kidney injury’

The study

Healthcare databases in Canada, UK and the US were used to gather data on 2,067,639 new statin users, defined as those who were prescribed a statin, but had no cholesterol lowering drug or prescription for niacin in the previous 365 days. High potency statin treatment was defined as at least 10mg rosuvastatin, at least 20mg atorvastatin, and at least 40mg simvastatin.

The findings

Patients who started high potency statins were 34% more likely to be hospitalised for acute kidney injury than those who started low potency statins, over the first 120 days of treatment, although this reduced to 11% when looking at 120 to 365 days post-therapy initiation. There was no significant difference in the rates of hospitalisation between those with chronic kidney disease and those with non-chronic kidney disease taking statins.

What does it mean for GPs?

The Canadian researchers concluded that ‘prescribers should consider the increased risk when contemplating use of high potency statins in clinical practice, particularly when treatment with a low potency statin is an option,’ adding that ‘a pressing question is how to identify patients for whom the risk-benefit balance for high potency statin treatment is unfavourable

BMJ 2013, online 20 March


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