New research using real-world patient data suggests that rosuvastatin, a statin drug widely prescribed to lower high cholesterol, may be associated with an increased risk of kidney damage compared to its counterpart atorvastatin. The study highlights concerns regarding hematuria, proteinuria, and even renal failure, especially at higher doses of rosuvastatin.
Key takeaways
- Use of rosuvastatin is associated with an increased risk of hematuria (blood in the urine), proteinuria (protein in the urine), and kidney failure requiring replacement therapy compared to atorvastatin.
- High doses of rosuvastatin appear to increase this risk.
- A large percentage of patients with advanced kidney disease have been prescribed doses of rosuvastatin that exceed FDA recommendations.
Understand the risks
Statins, including rosuvastatin, are crucial in managing high cholesterol, thus reducing the risk of heart attacks and strokes. However, recent findings published in the Journal of the American Society of Nephrology suggest possible harmful effects on kidney function. The study analyzed the electronic health records of more than 152,000 rosuvastatin users and nearly 800,000 atorvastatin users over a median follow-up period of 3.1 years.
Study results
The research revealed that rosuvastatin users had an 8% higher risk of hematuria, a 17% higher risk of proteinuria, and a 15% higher risk of developing kidney failure requiring dialysis or a kidney transplant compared to atorvastatin users. These risks have been found to be more pronounced at higher doses of rosuvastatin. Alarmingly, the study also found that 44% of patients with advanced kidney disease were prescribed doses of rosuvastatin higher than the maximum recommended by the FDA for individuals with poor kidney function.
Expert commentary
“Because rosuvastatin may cause proteinuria and hematuria, especially with high doses, a high dose of rosuvastatin may not be worth the risk — even a small one — especially for patients with advanced kidney disease,” said lead researcher Jung-Im Shin, MD, PhD, of the Johns Hopkins Bloomberg School of Public Health. This suggests that although rosuvastatin offers similar cardiovascular benefits to atorvastatin, the potential kidney risks, especially at higher doses or in high-risk patient groups, merit careful consideration.
