Statin Use and Association with Postoperative Estimated Glomerular Filtration Rates in Patients Undergoing Robot-Assisted Partial Nephrectomy

Abstract

Objective:

To evaluate the association between preoperative statin use with changes in estimated glomerular filtration rate (eGFR) after robot-assisted partial nephrectomy (RAPN).

Methods:

Three hundred eighty-nine consecutive patients undergoing RAPN were evaluated. Associations of preoperative statin use with change in eGFR from pre-RAPN to postoperative day 1 (POD1), 1, 6, and 12 months after RAPN were evaluated using longitudinal mixed-effects regression models with random patient-specific intercepts and slopes while accounting for imbalance of preoperative patient and tumor characteristics between groups with stabilized inverse propensity score weighting. Postoperative eGFR change from baseline was measured as total change, maintaining eGFR within 10% of baseline, and as going from eGFR >60 mL/min/1.73 m² to <60 mL/min/1.73 m².

Results:

One hundred sixty-seven (43.0%) of 389 patients were on statin therapy preoperatively. Statin patients were older (66 vs 58 years) and had higher rates of comorbidities, including diabetes mellitus (31.7% vs 14.9%) and hypertension (82.6% vs 45%). Statin patients tended to have lower preoperative eGFR (mean ± standard deviation, 71.1 ± 17.6 vs 77.4 ± 19.4 mL/min/1.73 m²). There was no evidence of an association of preoperative statin use with changes in eGFR at any time point after RAPN (p = 0.66).

Conclusion:

Patients on preoperative statins undergoing RAPN had lower eGFR preoperatively compared with those not taking those medications. There was no evidence of an association between preoperative statin use and change in post-RAPN eGFR in the immediate postoperative period or at 1 year after surgery.