Can High Doses of Drug Rosuvastatin Cause Kidney Damage?

New research based on patient health records on lowering high cholesterol suggests that rosuvastatin can harm the kidneys, especially at high doses of the medicine. For many patients with advanced kidney disease, a daily dose of rosuvastatin higher than that recommended for these patients is recommended. This study was reported in Journal of the American Society of Nephrology.

Statins are a group of drugs that help lower the level of cholesterol in blood and many people take rosuvastatin, one member of this drug class. Rosuvastatin was associated with higher risk of hematuria (blood in urine), proteinuria (protein in urine) and kidney failure requiring replacement therapy such as dialysis or transplant. Other statins might be safer for kidney health.

Kidney Damage due to Rosuvastatin

Reports had linked rosuvastatin with signs of kidney damage — hematuria and proteinuria — at the time of its approval by the US Food and Drug Administration, but little post-marketing surveillance exists to assess real-world risk.

‘Rosuvastatin was associated with an 8% higher risk of hematuria, a 17% higher risk of proteinuria and a 15% higher risk of developing kidney failure requiring replacement therapy such as dialysis or transplantation.’

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To investigate, Jung-Im Shin, MD, PhD (Johns Hopkins Bloomberg School of Public Health) and her colleagues analyzed electronic health record data for 152,101 new users of rosuvastatin and 795,799 new users of another statin called atorvastatin from 2011 to 2019.

Over a median follow-up of 3.1 years, the team identified hematuria in 2.9% of patients and proteinuria in 1.0% of patients. Compared with atorvastatin, rosuvastatin was associated with an 8% higher risk of hematuria, a 17% higher risk of proteinuria and a 15% higher risk of developing kidney failure requiring replacement therapy such as dialysis or transplantation.

Risks of hematuria and proteinuria were higher with a higher dose of rosuvastatin. Also, among patients with advanced kidney disease, 44% were prescribed a higher dose of rosuvastatin than the US Food and Drug Administration recommends for individuals with poor kidney function.

“We observed a higher risk of hematuria, proteinuria, as well as kidney failure with rosuvastatin use and similar cardiovascular benefits between the rosuvastatin and atorvastatin groups,” said Dr. Shin. “Because rosuvastatin may cause proteinuria and hematuria, especially with high dose, high dose rosuvastatin may not merit the risk — even if small — particularly for patients with advanced kidney disease.”

Dr. Shin’s co-authors include Derek M. Fine, MD; Yingying Sang, MS; Aditya Surapaneni, PhD; Stephan C. Dunning, MBA; Lesley A. Inker, MD, MS; Thomas D. Nolin, PharmD, PhD; Alex R. Chang, MD, MS; and Morgan E. Grams, MD, PhD.

Source-Eurekalert