Statins are well tolerated in kidney transplant recipients, but the cholesterol-lowering drugs may slightly increase the risks of specific adverse events, including post-transplant diabetes mellitus, a new study finds.
Investigators compared the effects of statin use and nonuse among 57,699 kidney transplant recipients on Medicare from the United States Renal Data System. Post-transplant diabetes mellitus occurred within 5 years in 43% of statin users and 35% of nonusers, Mara A. McAdams-DeMarco, PhD, of the NYU Grossman School of Medicine in New York, New York, and colleagues reported in the Clinical Journal of the American Society of Nephrology. The incidence rates of cataracts (22% vs 12%), hemorrhagic stroke (1.9% vs 1.4%), and rhabdomyolysis (1.5% vs 0.9%) were also higher among statin users. Liver injury occurred in a lower proportion of statin users (2% vs 3%), the investigators reported.
In multivariable analysis, statin use was significantly associated with a 12% higher risk of post-transplant diabetes mellitus, a 22% higher risk of cataracts, and a 37% higher risk of rhabdomyolysis. Statin use was significantly associated with an 18% lower risk of liver injury. Use of the drugs was not associated with hemorrhagic stroke. These associations did not differ by statin type.
The investigators adjusted the models for induction and maintenance immunosuppression agents.
“Although statins seem to be generally well tolerated in kidney transplant recipients with a safety profile similar to that in the general population, the potential effect of statins on post-transplant diabetes mellitus may warrant caution in recipients with high diabetes risk,” Dr McAdams-DeMarco’s team wrote.
Statins included atorvastatin, pravastatin, simvastatin, rosuvastatin, lovastatin, pitavastatin, and fluvastatin. Recipients who used multiple statins or other lipid-lowering agents were excluded from the study.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on Renal and Urology News
Bae S, Ahn JB, Joseph C, et al. Incidence of statin-associated adverse events in kidney transplant recipients. Clin J Am Soc Nephrol. Published online February 14, 2023. doi:10.2215/CJN.0000000000000124