Effects of statins on kidney function in older adults

Background: The effect of statin therapy on kidney function among older adults is unclear.

Objectives: To examine the association between statin use and changes in estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR), positive or negative, in an older adult cohort with versus without chronic kidney disease (CKD) at baseline.

Methods: This analysis included 18,056 participants aged ≥65 years with versus without CKD at baseline in a randomized trial of low-dose aspirin, who had no prior cardiovascular events, major physical disability, or dementia initially. Outcome measures included eGFR and UACR. Linear mixed-effects models were used to estimate the associations of baseline statin use versus no use with eGFR and UACR changes over time. The inverse-probability of treatment-weighting technique was used for all analyses to address confounding by indication due to the lack of randomization in treatment assignment.

Results: Statin use was not associated with change in eGFR, UACR, or incident CKD in participants with or without CKD at baseline (p > 0.05 for all associations). Subgroup analyses found no significant interactions between statin and age, sex, diabetes, country, and frailty status on any of the study outcomes.

Conclusions: Among adults ≥65 years of age, with and without CKD, statin therapy was not associated with improved or worsened kidney function. This data suggests that the decision to use versus not use statins in this population may be ideally guided by factors other than kidney health.