Effects of statins on the incidence and outcomes of acute kidney injury in critically ill patients: a systematic review and meta-analysis

Abstract

IntroductionIn critically ill patients, acute kidney injury (AKI) is a common complication with the very high mortality rates. We aimed to analyzse whether pre- and perioperative statins might prevent AKI and improve overall prognosis in patients in ICU.Material and methodsFollowing a systematic search of the literature, we performed a meta-analysis of selected clinical studies investigating the impact of statin treatment on the development and the clinical outcomes of AKI among subjects undergoing surgeries. The pooled odds ratios (OR) with 95% confidence intervals (CI) for the development of AKI and AKI-associated mortality, as well as the pooled mean differences (MD) and 95% CI for mean ICU stay and overall hospital length of stay were calculated for statin users compared to nonusers.ResultsOur results showed a highly significant association between statin use and the decrease in mortality of patients with AKI (OR 0.73, 95% CI: 0.69 - 0.77; p<0.001). The development of AKI (OR 0.92, 95% CI: 0.63 - 1.33; p=0.659) as well as the ICU stay (MD -0.02, 95% CI: -0.06 - 0.02; p=0.321) were not significantly affected, while the overall hospital length of stay (MD -0.49, 95% CI: -0.91 -0.07; p=0.020) was reduced. Subgroup analysis showed that both pre- and postoperative statin use were not associated with the risk of AKI.ConclusionsOur analysis showed a significant association between statin therapy and overall mortality of critically ill surgical patients diagnosed with AKI, while at the same time the use of statins did not affect the length of their stay in ICU.