Supplementary Material for: Statin Use and Incidence of Chronic Kidney Disease in Hypercholesterolemia Patients with Normal Renal Function

Introduction: Dyslipidemia is a known risk factor for chronic kidney disease (CKD). The effects of statins on CKD have already been studied in patients with CKD; however, data on the general population are limited. This study aimed to determine the relationship between statin use and the incidence of CKD in patients with hypercholesterolemia having normal renal function. Methods: A total of 7,856 participants aged 40–79 years at baseline (2009–2010) were included in the final analyses. The participants were divided into statin users (n = 4,168) and statin nonusers (n = 3,668), according to the statin usage. The Cox proportional hazard regression model was used to evaluate the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for CKD. Results: The median follow-up duration was 5.8 years. A total of 543 cases of CKD (285 cases in males and 258 cases in females) occurred during the study period. The estimated cumulative incidence of CKD was significantly different between male statin nonusers and users (p < 0.001), while it was not statistically significant between female statin nonusers and users (p = 0.126). Compared with statin nonusers, the fully adjusted HRs (95% CIs) for CKD in statin users were 1.014 (0.773–1.330) in males and 1.117 (0.843–1.481) in females. Conclusion: Dyslipidemia is an obvious risk factor for CKD; however, statin use in patients with hypercholesterolemia having normal renal function does not demonstrate a clear relationship with the incidence of CKD.

引言：血脂异常（Dyslipidemia）是慢性肾脏病（chronic kidney disease, CKD）的已知危险因素。已有研究针对慢性肾脏病患者探讨了他汀类药物对该病的影响，但针对普通人群的相关数据仍较为有限。本研究旨在明确肾功能正常的高胆固醇血症患者中，他汀类药物使用与慢性肾脏病发病率之间的关联。方法：最终纳入2009至2010年基线时年龄为40~79岁的7856名参与者进行最终分析。根据他汀类药物使用情况，将参与者分为他汀使用者（n=4168）与非使用者（n=3668）。采用Cox比例风险回归模型评估慢性肾脏病的校正后风险比（hazard ratios, HRs）及95%置信区间（confidence intervals, CIs）。结果：中位随访时长为5.8年。研究期间共发生543例慢性肾脏病事件，其中男性285例，女性258例。男性他汀使用者与非使用者的慢性肾脏病累计估计发病率存在显著统计学差异（p<0.001），而女性使用者与非使用者的该差异无统计学意义（p=0.126）。与非使用者相比，经完全混杂因素校正后，男性他汀使用者发生慢性肾脏病的风险比（95%CI）为1.014（0.773~1.330），女性为1.117（0.843~1.481）。结论：血脂异常是慢性肾脏病的明确危险因素，但在肾功能正常的高胆固醇血症患者中，他汀类药物的使用与慢性肾脏病发病率并未呈现明确的关联。