Millions of people around the world take medicines called statins every day to lower cholesterol and reduce their chances of heart attacks and strokes.
These medicines have helped save many lives by lowering harmful cholesterol levels and protecting the heart and blood vessels. One of the most widely used statins is rosuvastatin. It is often chosen because it is very effective at lowering cholesterol and is available to many patients.
However, a new study from researchers at Johns Hopkins University suggests that this commonly used medicine may carry a greater risk of kidney problems than another popular statin, especially when it is taken in higher doses. The findings may encourage doctors to think more carefully about which statin is the best choice for each patient.
Cholesterol is a fatty substance that the body needs in small amounts, but too much of it can build up inside blood vessels. Over time, these fatty deposits can narrow the arteries and reduce blood flow to the heart and brain.
This greatly increases the risk of heart disease and stroke. Statins help lower the amount of harmful cholesterol in the blood and have become one of the most commonly prescribed groups of medicines worldwide.
Like all medicines, statins can have side effects. Most people take them without serious problems, but doctors continue to study their long-term safety because uncommon side effects may only become clear after millions of people have used the medicines for many years.
When the U.S. Food and Drug Administration (FDA) first approved rosuvastatin, there were already reports that some patients developed blood in the urine, called hematuria, or protein in the urine, called proteinuria.
These signs can sometimes suggest that the kidneys are under stress or have been damaged. Even so, there was limited research to find out how often these problems happened in everyday medical practice.
To answer this question, the Johns Hopkins research team examined electronic health records collected between 2011 and 2019. They compared more than 150,000 people who began taking rosuvastatin with nearly 800,000 people who started another widely used statin called atorvastatin.
The researchers followed these patients for up to three years to see whether kidney problems developed over time.
The results showed that about 2.9% of people taking rosuvastatin developed blood in their urine, while around 1.0% developed protein in their urine.
Compared with people taking atorvastatin, those using rosuvastatin had an 8% higher risk of blood in the urine, a 17% higher risk of protein in the urine, and a 15% higher risk of severe kidney failure. The risks became even greater as the dose of rosuvastatin increased.
The researchers also found something especially worrying. Many people who already had serious kidney disease were prescribed doses of rosuvastatin that were higher than the FDA recommends for patients with poor kidney function.
Around 44% of patients with advanced kidney disease received doses that may have been too high for their condition. Because damaged kidneys cannot remove medicines from the body as efficiently, higher doses may increase the chance of harmful side effects.
The good news is that both rosuvastatin and atorvastatin appeared to provide similar protection against heart disease. This means patients may not lose heart benefits by using atorvastatin instead of rosuvastatin in some situations.
The findings suggest that doctors should carefully consider each patient’s kidney health before choosing a statin and pay close attention to the dose that is prescribed.
The researchers say these results do not mean that everyone taking rosuvastatin should stop using it. Many patients benefit greatly from the medicine, and people should never stop taking a prescribed drug without first speaking to their doctor.
Instead, the study highlights the importance of choosing the right medicine for the right patient and regularly checking kidney health, especially for people with existing kidney disease or those taking higher doses.
The study was published in the Journal of the American Society of Nephrology. It also reminds us why it is important to continue studying medicines after they reach the market. Clinical trials before approval cannot answer every question about long-term safety because they usually involve fewer people and shorter follow-up periods.
Real-world studies involving hundreds of thousands of patients can reveal rare side effects and help doctors improve treatment decisions. As researchers continue to learn more, these findings can lead to safer prescribing, better monitoring, and improved care for millions of patients around the world.
If you care about kidney health, please read studies about drug that prevents kidney failure in diabetes, and drinking coffee could help reduce risk of kidney injury.
For more information about kidney health, please see recent studies about foods that may prevent recurrence of kidney stones, and common painkillers may harm heart, kidneys and more.
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