Association between preoperative statin therapy and postoperative change in glomerular filtration rate in endovascular aortic surgery.
Acute kidney injury during endovascular aortic repair can result in a reduction in the postoperative glomerular filtration rate (GFR). The 'pleiotropic' effects of statins offer a potential mechanism of reducing the postoperative decline in the GFR. We therefore tested the hypothesis that in patients undergoing endovascular aortic repair, the GFR decreases less in patients taking preoperative statins than in those who do not. A cohort investigation of 501 consecutive patients who underwent endovascular aortic repair between June 2005 and March 2007 in an academic tertiary care centre. Multivariable linear regression was used to assess the association between the statin use and the postoperative GFR, after adjusting for the baseline GFR and other confounding covariables selected using a stepwise criterion. The statin use was not associated with a change in the postoperative GFR (P=0.94); the difference (95% confidence interval) in the mean postoperative GFR (statins minus no statins) was estimated at 0.1 (-3.1, +3.4) ml min(-1) 1.73 m(-2). A decrease in the GFR of ≥ 25% (the threshold to diagnose contrast-induced nephropathy) developed in 26 of 192 patients given statins before operation (13.5%) compared with 36 of 296 patients who were not taking statins (12.2%). Statin therapy is not associated with a statistically significant change in the mean postoperative GFR in patients undergoing endovascular aortic surgery, nor a reduction in the risk of a GFR decline of >25%.