Statin use and sepsis events [corrected] in patients with chronic kidney disease

JAMA. 2007 Apr 4;297(13):1455-64. doi: 10.1001/jama.297.13.1455.


Context: Patients with chronic kidney disease are at high risk for sepsis and sepsis-related mortality.

Objective: To assess whether statin use is associated with a reduction in sepsis events [corrected] in dialysis patients.

Design, setting, and patients: National prospective cohort study that enrolled 1041 incident dialysis patients at 81 US not-for-profit outpatient dialysis clinics from October 1995 to June 1998, with follow-up to January 2005. Statin use was determined by medical record review. Rates of sepsis events [corrected] between statin users and control patients were compared using multivariate regression models, with adjustment for potential confounders in the overall cohort and in a subcohort in which control patients were matched to statin users according to their likelihood (propensity) to have been prescribed a statin.

Main outcome measure: Sepsis events [corrected] were determined through hospital records from the United States Renal Data System (mean follow-up, 3.4 years).

Results: There were 303 sepsis events [corrected] Rates of sepsis events [corrected] were significantly lower in patients receiving statins (crude incidence rate, 41/1000 patient-years) than in those not receiving statins (crude incidence rate, 110/1000 patient-years) (P<.001). With adjustment for demographics and dialysis modality, statin users were substantially less likely to be subsequently hospitalized for sepsis (incidence rate ratio, 0.41; 95% confidence interval [CI], 0.25-0.68). Further adjustment for comorbidities and laboratory values continued to show this protective association (incidence rate ratio, 0.38; 95% CI, 0.21-0.67). In the propensity-matched subcohort, statin use was even more protective (incidence rate ratio, 0.24; 95% CI, 0.11-0.49).

Conclusions: Use of statins was strongly and independently associated with a reduction in the risk of sepsis events [corrected] in patients who had chronic kidney disease and were receiving dialysis. Randomized trials of statins in patients with chronic kidney disease should examine the prevention of sepsis as a potentially important benefit.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / therapy*
  • Sepsis / epidemiology*
  • Sepsis / prevention & control


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors