Statin does not protect against acute kidney injury following cardiac surgery

Although statins affect mechanisms that lead to postoperative acute kidney injury (AKI), observational studies have failed to demonstrate a consistent effect of statin therapy on the risk of AKI after cardiac surgery. The Statin AKI Cardiac Surgery randomized control trial sought to determine if high-dose, short-term atorvastatin reduced the risk of AKI following cardiac surgery. This double-blind, placebo-controlled, single center trial, evaluated high-dose perioperative atorvastatin on AKI in 615 patients undergoing elective coronary artery bypass surgery, valvular heart surgery, or ascending aortic surgery. The intervention arm received atorvastation 80 mg the day prior to surgery, 40mg day of surgery, and 40 mg daily for the duration of hospitalization. Patients were randomized with stratification for prior statin use, presence of chronic kidney disease (GFR<60 ml/min/1.73 m²), and history or diabetes. The primary outcome of AKI was defined as an increase of 0.3 mg/dL in serum creatinine or initiation of renal replacement therapy within 48 hours of surgery. The study was terminated after a second interim analysis for concern of increased risk of AKI among statin …