Statins reduce sepsis risk in CKD

Statins could reduce the risk of sepsis in chronic kidney disease (CKD) patients receiving dialysis, according to US research.

Preventive treatment for sepsis has yet to be identified, but the latest study findings suggest that statins may be able to minimise the risk of sepsis in CKD patients by regulating the immune response to infection.

Statins may also play a role in reducing the production of cytokines or mitigating the vasodilatory response to cytokines that results in septic shock, say the researchers.

For this latest study, the association of statin use with the occurrence of sepsis was examined in 1,041 CKD patients who were receiving dialysis for end stage renal disease, 143 of which were statin users, enrolled at 80 US dialysis clinics over a period of three years.

Statin use was determined by review of the dialysis clinic notes and hospital discharge summaries, while a history of sepsis was collected from self-report questionnaires and hospital records from the US renal data system.

Over the duration of the study, 303 participants were hospitalised for sepsis.

The risk of hospitalisation for sepsis was 62 per cent lower among statin users than among those not using statins.

East London GP Dr Penny Ackland, who has an interest in CKD, said that the findings were interesting: ‘Sepsis is a big problem in CKD patients that have been hospitalised. You can’t, however, extrapolate the results of this study to pre-dialysis patients. The benefits of statin use are limited to the CKD patients on dialysis.’

More evidence is needed to show whether or not statins can reduce the progression of kidney disease before you can say that GPs prescribe statins to CKD patients, said Dr Ackland.

But West London GP Dr Sarah Jarvis, a member of the Primary Care Cardiovascular Society, said the results highlighted another opportunity to prescribe statins to CKD patients, saying: ‘GPs are seeing more and more cases of CKD, as the number of people with diabetes increases and the population gets older.

‘Giving statins to CKD patients could also reduce the risk of having a cardiovascular event. CKD patients are actually more likely to develop cardiovascular disease (CVD) before they develop end stage renal failure.’

Figures have shown that patients with stage-four CKD are six times more likely to have CVD, said Dr Jarvis.

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