Statins are widely used to lower high cholesterol, and many people rely on rosuvastatin, a popular medication in this drug class. While effective in reducing cholesterol and improving heart health, new research from Johns Hopkins University highlights potential risks to kidney health, particularly with higher doses of rosuvastatin.
The study analyzed electronic health records of 152,101 individuals who began taking rosuvastatin and compared them to 795,799 new users of atorvastatin, another commonly prescribed statin, over an eight-year period from 2011 to 2019.
The follow-up period lasted three years, during which researchers tracked signs of kidney damage, such as hematuria (blood in the urine) and proteinuria (protein in the urine), as well as instances of kidney failure requiring treatments like dialysis or transplantation.
The findings revealed that 2.9% of patients on rosuvastatin experienced hematuria, while 1.0% developed proteinuria.
When compared to atorvastatin users, those on rosuvastatin faced an 8% higher risk of hematuria, a 17% higher risk of proteinuria, and a 15% higher risk of severe kidney failure necessitating replacement therapy. These risks were even more pronounced at higher doses of rosuvastatin.
The study also raised concerns about the prescribing practices for patients with advanced kidney disease.
Among this group, 44% were prescribed higher doses of rosuvastatin than the U.S. Food and Drug Administration (FDA) recommends for individuals with poor kidney function. This practice may unnecessarily increase the likelihood of kidney-related side effects.
Despite the risks, the heart-related benefits of rosuvastatin were found to be similar to those of atorvastatin. This raises the question of whether the increased kidney risks with high-dose rosuvastatin are justified, particularly for patients with existing kidney problems.
The researchers emphasized the importance of weighing the benefits and risks of rosuvastatin, especially for individuals at higher risk of kidney damage. They recommend cautious use of high doses, particularly in patients with advanced kidney disease, to minimize potential harm.
This study builds on earlier concerns about rosuvastatin’s kidney effects, which were noted during its initial FDA approval, linking the drug to signs of hematuria and proteinuria. However, there has been limited follow-up on these risks in real-world settings until now.
For those concerned about kidney health, it is essential to discuss the potential risks and benefits of statins with a healthcare provider. Adjusting the dosage or considering alternative medications may help reduce the likelihood of side effects while still managing cholesterol effectively.
The research, led by Jung-im Shin, was published in the Journal of the American Society of Nephrology. For more insights into kidney health, consider exploring studies on diabetes drugs that could reduce chronic kidney disease and the protective effects of certain vegetables against diabetes-related kidney damage.
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