Trends in Statin Use Among US Adults With Chronic Kidney Disease, 1999-2014
Trends in Statin Use Among US Adults With Chronic Kidney Disease, 1999-2014
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DOI：
10.1161/jaha.118.010640
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发表时间：
2019-01-22
影响因子：
5.4
通讯作者：
Muntner, Paul
中科院分区：
文献类型：
--
作者：
Mefford, Matthew T.;Rosenson, Robert S.;Muntner, Paul
背景2013年美国心脏病学会/美国心脏协会胆固醇指南将心血管疾病和糖尿病而非慢性肾脏病（CKD）视为不接受他汀类药物治疗的高危疾病。他汀类药物的使用可能是较低的成人慢性肾脏病与成人的条件相比，有指导性的迹象，他汀类药物use.Methods和结果，我们分析了从1999-2002年通过2011-2014年的国家健康和营养检查调查的数据，以确定趋势的百分比美国成年人>= 20岁的慢性肾脏病和不服用他汀类药物。CKD定义为估计的肾小球滤过率= 30 mg/g。他汀类药物的使用是通过药物清单确定的。在1999-2002年和2011-2014年之间，CKD患者中服用他汀类药物的成年人比例从17.6%增加到357%，无CKD患者从6.8%增加到147%。经多变量校正后，与无CKD的成人相比，CKD成人服用他汀类药物的可能性并不高（患病率比，1.01; 95%CI] 0.96-1.08）。在无心血管疾病史的成人中，与糖尿病但无CKD的患者相比，CKD但无糖尿病的患者服用他汀类药物的可能性更低（患病率比，0.54; 95%CI，0.44-0.66）。在有心血管疾病史的成年人中，CKD但非糖尿病患者与糖尿病但非CKD患者之间他汀类药物的使用没有差异（患病率比，0.95; 95%CI，0.79-1.15）。结论CKD似乎不是美国成年人使用他汀类药物的主要刺激因素。
Background The 2013 American College of Cardiology/American Heart Association cholesterol guidelines recognize cardiovascular disease and diabetes mellitus but not chronic kidney disease (CKD) as high-risk conditions warranting statin therapy. Statin use may be lower for adults with CKD compared with adults with conditions that have guideline indications for statin use.Methods and Results We analyzed data from the National Health and Nutrition Examination Surveys from 1999-2002 through 2011-2014 to determine trends in the percentage of US adults >= 20 years of age with and without CKD taking statins. CKD was defined by an estimated glomerular filtration rate = 30 mg/g. Statin use was identified through a medication inventory. Between 1999-2002 and 2011-2014, the percentage of adults taking statins increased from 17.6% to 357% among those with CKD and from 6.8% to 147% among those without CKD. After multivariable adjustment, adults with CKD were not more likely to be taking statins compared with those without CKD (prevalence ratio, 1.01; 95% CI] 0.96-1.08). Among adults without a history of cardiovascular disease, those with CKD but not diabetes mellitus were less likely to be taking statins compared with those with diabetes mellitus but not CKD (prevalence ratio, 0.54; 95% CI, 0.44-0.66). Among adults with a history of cardiovascular disease, there was no difference in statin use between those with CKD but not diabetes mellitus versus those with diabetes mellitus but not CKD (prevalence ratio, 0.95; 95% Cl, 0.79-1.15).Conclusions CKD does not appear to be a major stimulus for statin use among US adults.