High-potency statins increase the risk of acute kidney injury: Evidence from a large population-based study

  • Giovanni Corrao
    Corresponding author. Dipartimento di Statistica e Metodi Quantitativi, Sezione di Biostatistica, Epidemiologia e Sanità Pubblica, Università degli Studi di Milano-Bicocca, Via Bicocca degli Arcimboldi, 8, Edificio U7, 20126 Milano, Italy. Tel.: +39 02 64485854; fax: +39 02 64485899.
    Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
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  • Davide Soranna
    Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
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  • Manuela Casula
    Centre of Epidemiology and Preventive Pharmacology (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milano, Milan, Italy
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  • Luca Merlino
    Operative Unit of Territorial Health Services, Region Lombardia, Milan, Italy
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  • Maria Gabriella Porcellini
    Division of Paediatric Nephrology, Paediatric Hospital “Regina Margherita”, Turin, Italy
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  • Alberico L. Catapano
    Centre of Epidemiology and Preventive Pharmacology (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milano, Milan, Italy

    IRCSS Multimedica, Milan, Italy
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      • We performed a nested case-control study linking healthcare utilization databases.
      • We studied the effect of the potency of statins on the risk of acute kidney injury.
      • Use of high-potency statins seems to increase the risk of acute kidney injury.
      • Use of low-potency statins was not associated to the risk of acute kidney injury.
      • No evidence was observed increasing follow-up or for chronic kidney disease.



      To assess the association between acute kidney injury and exposure to either high-potency statins or low-potency statins.


      A population-based, nested case-control study was performed on a cohort of 316,449 patients from Lombardy (Italy) newly treated with statins between 2007 and 2010 aged 40 years or older. 458 patients experienced acute kidney injury within six months after initial statin prescription. Up to four controls were randomly selected for each case. Logistic regression was used to model the outcome risk associated with high-potency contrasted with low-potency statins dispensed at starting therapy, and during follow-up.


      Patients at whom high-potency statins were initially dispensed were more likely to be hospitalized for acute kidney injury within six months after starting treatment than those on low-potency statins (adjusted OR 1.54, 95% confidence interval 1.25–1.91). Patients receiving high-potency statins within three weeks before the outcome onset had a significant increased risk respect to those who did not receive statins during the same time-window (adjusted OR 1.45, 95% confidence interval 1.04–2.03). When follow-up was extended from 6 months to 12 months the difference was not significant anymore (adjusted OR 1.17, 95% confidence interval 0.89–1.54).


      Use of high-potency statins is associated with an increased risk of acute kidney injury compared with low-potency statins in the first 6 months after starting therapy.


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