| Statin therapy is not associated with improved vascular access outcomes. | |
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MedLine Citation:
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PMID: 20507962 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Neointimal hyperplasia is the major cause of vascular access failure in hemodialysis patients. Statins reduce neointimal hyperplasia in experimental models, which may reduce access failure. The study presented here evaluated whether vascular access outcomes are superior in patients receiving statin therapy than in those not on statins. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective computerized vascular access database was retrospectively queried to determine the access outcomes of 601 patients receiving an upper-arm fistula or graft at a single large dialysis center. RESULTS: Primary fistula failure was observed in 37% of patients on statin therapy versus 38% not on statin therapy. Primary graft failure occurred in 20% of patients on statin therapy versus 14% not on statin therapy. A multiple variable logistic regression analysis including statin use, diabetes, coronary artery disease, peripheral artery disease, sex, and age found that only sex predicted primary fistula failure and graft failure. After excluding primary failures, cumulative fistula survival was similar for patients with or without statin therapy (hazard ratio [HR] 1.26; 95% confidence interval [CI] 0.76 to 2.16). Likewise, cumulative graft survival was similar for statin therapy versus no statin therapy (HR 0.88; 95% CI 0.59 to 1.32). Using a multivariable survival analysis model to predict cumulative fistula survival, only age predicted fistula failure (HR 1.21 per decade; 95% CI 1.02 to 1.44). None of the variables in this model predicted cumulative graft survival. CONCLUSIONS: Statin therapy is not associated with improved fistula or graft outcomes in patients with chronic kidney disease. |
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Authors:
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Roberto Pisoni; Jill Barker-Finkel; Michael Allo |
Publication Detail:
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Type: Journal Article Date: 2010-05-27 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 5 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-09 Completed Date: 2010-11-30 Revised Date: 2011-08-03 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1447-50 Citation Subset: IM |
Affiliation:
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Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Alabama Arteriovenous Shunt, Surgical / adverse effects* Blood Vessel Prosthesis Implantation / adverse effects* Chronic Disease Female Graft Occlusion, Vascular / etiology* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Kidney Diseases / therapy* Logistic Models Male Middle Aged Odds Ratio Renal Dialysis* Retrospective Studies Risk Assessment Risk Factors Treatment Outcome Upper Extremity / blood supply* |
| Chemical | |
Reg. No./Substance:
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0/Hydroxymethylglutaryl-CoA Reductase Inhibitors |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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