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High-Dose Statins Linked to Acute Kidney Damage

Large study doesn't prove connection, but experts say patients should ask doctors about concerns
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WebMD News from HealthDay

By Denise Mann

HealthDay Reporter

TUESDAY, March 19 (HealthDay News) -- People who take high doses of popular cholesterol-lowering drugs called statins may be more likely to develop kidney problems, a new study suggests.

Specifically, those participants who took higher doses of statins were 34 percent more likely to be hospitalized for acute kidney injury during the first 120 days of treatment, compared to their counterparts who were taking lower doses. This risk remained elevated two years after starting treatment. The findings appeared online March 19 in the journal BMJ.

Statins are widely prescribed to lower blood cholesterol levels, and can be very effective. They do, however, confer their share of risks, most notably liver damage and muscle pain or weakness. Doctors currently recommend that people take a liver enzyme test before or shortly after they begin taking statins. The issue of kidney damage as seen in the current study, however, is relatively new.

Canadian researchers analyzed the health records from more than 2 million people aged 40 or older with or without kidney disease who were also taking statins. High-dose statins included rosuvastatin (Crestor) at doses of 10 milligrams (mg) or higher, atorvastatin (Lipitor) at doses of 20 mg or higher and simvastatin (Zocor) at doses of 40 mg. All other statin doses were considered low dose.

People with kidney disease were not at higher risk for acute kidney problems independent of their statin use, the study found.

To illustrate the effect of statin dosage, about 1,700 people without kidney disease would need to be treated with a high-dose statin rather than a low-dose version to cause one additional hospitalization for kidney injury, the researchers said.

"The lowest dose of statin required to achieve therapeutic goals should be prescribed," said study author Colin Dormuth, an epidemiologist at the University of British Columbia, in Vancouver.

Exactly how -- or even if -- statins cause kidney injury is not known. "The elevated risk in patients using high-potency statins could be related to an increased risk of [muscle damage]," Dormuth said. In addition, statins have been shown to block the production of coenzyme Q10 (a substance in the body that helps break down food), which could theoretically lead to kidney injury, he said.

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Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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