Pilot double-blind, randomized controlled trial of short-term atorvastatin for prevention of acute kidney injury after cardiac surgery
Article first published online: 23 FEB 2012
© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology
Volume 17, Issue 3, pages 215–224, March 2012
How to Cite
PROWLE, J. R., CALZAVACCA, P., LICARI, E., LIGABO, E. V., ECHEVERRI, J. E., HAASE, M., HAASE-FIELITZ, A., BAGSHAW, S. M., DEVARAJAN, P. and BELLOMO, R. (2012), Pilot double-blind, randomized controlled trial of short-term atorvastatin for prevention of acute kidney injury after cardiac surgery. Nephrology, 17: 215–224. doi: 10.1111/j.1440-1797.2011.01546.x
- Issue published online: 23 FEB 2012
- Article first published online: 23 FEB 2012
- Accepted manuscript online: 24 NOV 2011 12:45PM EST
- Accepted for publication 13 November 2011.; Accepted manuscript online 24 November 2011.
- acute kidney injury;
- cardiac surgery;
- cardiopulmonary bypass;
- HMG-CoA reductase inhibitor;
- neutrophil gelatinase-associated lipocalin;
- randomized controlled trial
Aim: To test whether short-term perioperative administration of oral atorvastatin could reduce incidence of postoperative acute kidney injury (AKI) in cardiac surgical patients.
Methods: We conducted a double-blind, randomized controlled trial in 100 cardiac surgical patients at increased risk of postoperative AKI. Patients were randomized to atorvastatin (40 mg once daily for 4 days starting preoperatively) or identical placebo capsule. Primary outcome was to detect a smaller absolute rise in postoperative creatinine with statin therapy. Secondary outcomes included AKI defined by the creatinine criteria of RIFLE consensus classification (RIFLE R, I or F), change in urinary neutrophil gelatinase-associated lipocalin (NGAL) concentration, requirement for renal replacement therapy, length of stay in intensive care, length of stay in hospital and hospital mortality.
Results: Study groups were well matched. For each patient maximal increase in creatinine during the 5 days after surgery was assessed; median maximal increase was 28 µmol/L in the atorvastatin group and 29.5 µmol/L in the placebo group (P = 0.62). RIFLE R or greater occurred in 26% of patients with atorvastatin and 32% with placebo (P = 0.65). Postoperatively urine NGAL changes were similar (median NGAL : creatinine ratio at intensive care unit admission: atorvastatin group 1503 ng/mg, placebo group 1101 ng/mg; P = 0.22). Treatment was well tolerated and adverse events were similar between groups.
Conclusion: Short-term perioperative atorvastatin use was not associated with a reduced incidence of postoperative AKI or smaller increases in urinary NGAL. (ClinicalTrials.gov NCT00910221).