Korean J Transplant.  2022 Nov;36(Supple 1):S272. 10.4285/ATW2022.F-4115.

Clinical effect of early statin uses in kidney transplant recipients: results from the KNOW-KT study

• Yim SH
• Lee J
• Yang J
• Huh KH

• KMID: 2535499
• DOI: http://doi.org/10.4285/ATW2022.F-4115

Abstract

Background
Cardiovascular disease remains a leading cause of morbidity and death with a functioning graft after kidney transplantation. Although statins reduce cardiovascular risk and have renal benefits in the general population, their beneficial effects in kidney transplant recipients have not been well established.
Methods
We studied whether early statin use affects long-term transplant outcomes in 714 kidney transplant recipients from the Korean cohort study for outcome in patients with kidney transplantation (KNOW-KT). Patients were divided into a group that received statins within 1 year after transplantation (statin group) and a group that did not (no statin group).
Results
In total, the mean age of the 714 recipients was 45.6 years, 83.1% received a kidney from a living donor, and 25.5% had diabetes mellitus at the time of transplantation. Compared with no statin group, statin group recipients were significantly older, had a higher body mass index, and were more likely to have diabetes mellitus. During a median follow-up of 85 months, 74 graft losses occurred (54 graft failures and 15 patient deaths). A multivariable analysis confirmed that early statin use was in-dependently associated with lower all-cause graft loss (hazard ratio, 2.441; 95% confidence interval, 1.395–4.271). Low-density lipoprotein (LDL) cholesterol levels were higher in the statin group at the time of transplant, but from 1-year posttransplant, LDL cholesterol levels of the statin group were consistently lower than those of the no statin group. A total of 37 major cardiovascular adverse events occurred. Although statin group had a higher crude incidence of major cardiovascular adverse event, multivariate analysis showed no significant difference between two groups. There were no significant differences between two groups in biopsy-proven acute rejection and graft renal function.
Conclusions
Among the kidney transplant recipients, early statin use effectively lowers LDL cholesterol levels and is associated with a lower risk of all-cause graft loss.