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Statin Use Is Associated with Prolonged Survival of Renal Transplant Recipients

Franz Wiesbauer^*, Georg Heinze, Christa Mitterbauer, Franz Harnoncourt, Walter H. Hörl and Rainer Oberbauer^,

^* Departments of Cardiology, Core Unit of Medical Statistics and Informatics, and Department of Nephrology, Medical University of Vienna, Vienna, and Department of Nephrology, KH Elisabethinen, Linz, and Austrian Dialysis and Transplant Registry, Wels, Austria

Correspondence: Dr. Rainer Oberbauer, Department of Nephrology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Phone: +43-732-7676-4305; Fax: +43-732-7676-4306; E-mail: rainer.oberbauer{at}meduniwien.ac.at

Received for publication January 25, 2008. Accepted for publication June 10, 2008.

The efficacy of statins for the prevention of cardiovascular events is well established in the general population but remains unknown in renal transplant recipients. In this study, the association of statin use with patient and graft survival was investigated in a cohort of 2041 first-time recipients of renal allografts between 1990 and 2003. Multivariable Cox regression demonstrated that statin use was independently associated with lower mortality rates. Twelve-year survival rates were 73% for statin users and 64% for nonusers (P = 0.055). The adjusted hazard ratio for all-cause mortality associated with statin use was 0.64 (95% confidence interval 0.48 to 0.86). Graft survival rates during the same time period were 76% for statin users and 70% for nonusers (P = 0.055). The adjusted hazard ratio for graft survival associated with statin use was 0.76 (95% confidence interval 0.55 to 1.04). Results from marginal structural models were virtually identical. In summary, statin use was associated with prolonged patient survival, but no difference in graft survival was detected. Although these results are encouraging, a definitive causal relationship can be determined only from randomized clinical trials.

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Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673