Pilot double-blind, randomized controlled trial of short-term atorvastatin for prevention of acute kidney injury after cardiac surgery

John R. Prowle, Paolo Calzavacca, Elisa Licari, Emmanuela V. Ligabo, Jorge E. Echeverri, Michael Haase, Anja Haase-Fielitz, Sean M. Bagshaw, Prasad Devarajan, Rinaldo Bellomo

Research output: Contribution to journalArticleResearchpeer-review

54 Citations (Scopus)

Abstract

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). In this randomized, double-blind clinical trial in 100 cardiac surgical patients at increased risk of postoperative acute kidney injury, atorvastatin 40 mg/day given for 4 days did not change the likelihood of elevation in serum creatinine or urinary neutrophil gelatinase-associated lipocalin.

Original languageEnglish
Pages (from-to)215-224
Number of pages10
JournalNephrology
Volume17
Issue number3
DOIs
Publication statusPublished - Mar 2012
Externally publishedYes

Keywords

  • acute kidney injury
  • cardiac surgery
  • cardiopulmonary bypass
  • HMG-CoA reductase inhibitor
  • neutrophil gelatinase-associated lipocalin
  • randomized controlled trial

Cite this

Prowle, J. R., Calzavacca, P., Licari, E., Ligabo, E. V., Echeverri, J. E., Haase, M., Haase-Fielitz, A., Bagshaw, S. M., Devarajan, P., & Bellomo, R. (2012). Pilot double-blind, randomized controlled trial of short-term atorvastatin for prevention of acute kidney injury after cardiac surgery. Nephrology, 17(3), 215-224. https://doi.org/10.1111/j.1440-1797.2011.01546.x