Statin Use and Hospitalization for Sepsis in Patients With Chronic Kidney Disease

CONTEXT Patients with chronic kidney disease are at high risk for sepsis and sepsis-related mortality. OBJECTIVE To assess whether statin use is associated with a reduction in hospitalizations for sepsis in dialysis patients. DESIGN, SETTING, AND PATIENTS National prospective cohort study that enrol...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2007-04, Vol.297 (13), p.1455-1464
Main Authors: Gupta, Rajesh, Plantinga, Laura C, Fink, Nancy E, Melamed, Michal L, Coresh, Josef, Fox, Caroline S, Levin, Nathan W, Powe, Neil R
Format: Article
Language:English
Subjects:
Bacterial diseases
Bacterial sepsis
Biological and medical sciences
Clinics
General aspects
Hemodialysis
Human bacterial diseases
Infections
Infectious diseases
Kidney diseases
Kidneys
Medical sciences
Mortality
Nephrology. Urinary tract diseases
Risk factors
Statins
Urinary system involvement in other diseases. Miscellaneous
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Summary:CONTEXT Patients with chronic kidney disease are at high risk for sepsis and sepsis-related mortality. OBJECTIVE To assess whether statin use is associated with a reduction in hospitalizations for sepsis in dialysis patients. DESIGN, SETTING, AND PATIENTS National prospective cohort study that enrolled 1041 incident dialysis patients at 81 US not-for-profit outpatient dialysis clinics from October 1995 to June 1998, with follow-up to January 2005. Statin use was determined by medical record review. Rates of hospitalization for sepsis between statin users and control patients were compared using multivariate regression models, with adjustment for potential confounders in the overall cohort and in a subcohort in which control patients were matched to statin users according to their likelihood (propensity) to have been prescribed a statin. MAIN OUTCOME MEASURE Hospitalizations for sepsis were determined through hospital records from the United States Renal Data System (mean follow-up, 3.4 years). RESULTS There were 303 hospitalizations for sepsis. Rates of sepsis-related hospitalizations were significantly lower in patients receiving statins (crude incidence rate, 41/1000 patient-years) than in those not receiving statins (crude incidence rate, 110/1000 patient-years) (P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.297.13.1455