Division of Nephrology, Department of Medicine, University of Western Ontario, London, Canada.
J Am Soc Nephrol. 2011 May;22(5):939-46. doi: 10.1681/ASN.2010050442. Epub 2011 Apr 14.
Statins abrogate ischemic renal injury in animal studies but whether they are renoprotective in humans is unknown. We conducted a population-based retrospective cohort study that included 213,347 older patients who underwent major elective surgery in the province of Ontario, Canada from 1995 to 2008. During the first 14 postoperative days, 1.9% (4020 patients), developed acute kidney injury and 0.5% (1173 patients), required acute dialysis. The 30-day mortality rate was 2.8% (5974 patients). Prior to surgery, 32% of patients were taking a statin. After statistical adjustment for patient and surgical characteristics, statin use associated with 16% lower odds of acute kidney injury (OR, 0.84; 95% CI, 0.79 to 0.90), 17% lower odds of acute dialysis (OR, 0.83; 95% CI, 0.72 to 0.95), and 21% lower odds of mortality (OR, 0.79; 95% CI, 0.74 to 0.85). Propensity score matching produced similar results. These data suggest that statins may protect against renal complications after major elective surgery and reduce perioperative mortality.
他汀类药物在动物研究中可消除缺血性肾损伤，但它们在人类中是否具有肾脏保护作用尚不清楚。我们进行了一项基于人群的回顾性队列研究，该研究纳入了 2008 年期间在加拿大安大略省接受主要择期手术的 213347 名老年患者。术后 14 天内，1.9%（4020 例）发生急性肾损伤，0.5%（1173 例）需要急性透析。30 天死亡率为 2.8%（5974 例）。手术前，32%的患者正在服用他汀类药物。在对患者和手术特征进行统计调整后，他汀类药物的使用与急性肾损伤的几率降低 16%相关（OR，0.84；95%CI，0.79 至 0.90），急性透析的几率降低 17%（OR，0.83；95%CI，0.72 至 0.95），死亡率的几率降低 21%（OR，0.79；95%CI，0.74 至 0.85）。倾向评分匹配得出了类似的结果。这些数据表明，他汀类药物可能有助于预防主要择期手术后的肾脏并发症，并降低围手术期死亡率。
