Background: Effects of statins on kidneys in diabetic patients remain unclear.
Methods: This was an observational, historical cohort study of type 2 diabetic patients with estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2. We studied 412 patients newly prescribed statins, and 946 controls without a prescription history of statins (including the follow-up period). Outcomes were annual change in eGFR, ≥30 % decrease in eGFR from baseline, and progression of albuminuria, analyzed using a propensity score matching.
Results: A total of 168 pairs were matched for propensity score. Annual eGFR change (mL/min/1.73 m2/year) in the statin group was greater than in controls (-2.24 vs. -1.56, p = 0.024). The hazard ratio of the statin group (vs. controls) for ≥30 % decrease in eGFR and progression of albuminuria was 1.74 (p = 0.082) and 0.85 (p = 0.624), respectively. When the statin group was classified by differences in statin solubility, eGFR change and hazard ratio for ≥30 % decrease in eGFR in the lipophilic statin group were greater than in controls (-2.64 vs. -1.71, p = 0.031 and 2.15, p = 0.049); however, the outcomes in the hydrophilic statin group were not different (-2.35 vs. -1.71, p = 0.106 and 1.08, p = 0.827). The hazard ratio of lipophilic and hydrophilic statin group (vs. controls) for progression of albuminuria was 1.31 (p = 0.552) and 0.69 (p = 0.367). In the analyses using the unmatched cohort, similar results were obtained.
Conclusions: Statins have no beneficial effects on kidneys in diabetic patients. In fact, lipophilic statins might have potential harmful effects on kidney function.
Keywords: Diabetes; Kidney; Statin.