NEW YORK (Reuters Health) – High-dose atorvastatin does not protect against contrast-induced nephropathy (CIN) in patients with kidney disease, Italian researchers report.

“Statins have recently been proposed for prevention of CIN given their antioxidant and anti-inflammatory properties,” Dr. Anna Toso and colleagues, from Misericordia e Dolce Hospital, Prato, note. “Different specific studies have produced conflicting results.”

The current study involved 304 patients with an estimated creatinine clearance at baseline of < 60 mL/min who were undergoing coronary angiography. The subjects were randomized to receive atorvastatin 80 mg/day or placebo for 48 hours before and 48 hours after iso-osmolar contrast administration. All patients also received oral N-acetylcysteine, at a dose of 1200 mg twice daily from the day before to the day after the procedure, as well as routine IV hydration. According to the report in the December 21st issue of the American Journal of Cardiology, CIN rates were similar in the two groups. Fifteen atorvastatin patients (10%) and 16 placebo patients (11%) developed CIN, defined as an absolute rise in serum creatinine of 0.5 mg/dL or greater within 5 days of the procedure (p = 0.86). Likewise, the average creatinine increase in each group was similar: 0.72 mg/dL in the atorvastatin group vs. 0.59 mg/dL in the placebo group (p = 0.31). And finally, persistent kidney injury, defined as a 1-month rise from baseline creatinine of at least 25%, occurred with nearly the same frequency in each group: 31% in the atorvastatin group vs. 30% in the placebo group (p = 0.58). “We chose high-dose atorvastatin for its proved efficacy in primary and secondary prevention of cardiovascular events, mainly in patients with chronic kidney disease,” the authors state. “However, the results of our study showed that short-term high-dose atorvastatin not only produced no early benefit in the decrease of acute iatrogenic renal damage, but also failed to limit the 1-month kidney function loss expressed by the similar persistence of 1-month altered creatinine values in the statin control groups.” Reference:
Am J Cardiol 2009.