Effect of rosuvastatin on postoperative urine protein in patients with diabetes associated with mild renal insufficiency

OBJECTIVE: To assess the effect of rosuvastatin used during perioperative period on urine trace protein in patients with type 2 diabetes mellitus (T2DM) and concomitant chronic kidney disability (CKD, stage 2). METHODS: From Dec. 2008 to Oct. 2011, 2998 patients from 53 centers in China were enrolled in a TRACK-D project. Of them, 2360 patients with T2DM and concomitant CKD (stage 2) were assigned to rosuvastatin group (n=1185) and control group (n=1175). Patients in rosuvastatin group were treated by an intake of rosuvastatin 10mg/d every night for five days (two days pre- and three days post-operation), while those in control group did not receive statins before operation and within 72 hours after operation. The urine trace protein, serum creatinine (Scr) and the excretion of urinary microalbumin were measured 48 hours before and 72 hours after the operation, and the incidence of contrast-induced aucte kidney injury (CIAKI) was simultaneously observed. A 30-day clinical follow-up was done, including the incidence of cardiovascular events, drug adverse events and all-cause mortality. RESULTS: There was no significant difference in urinary microalbumin excretion between rosuvastatin group and control group in either pre-operative stage (0.25±0.38mg/L vs 0.28±0.41mg/L, P=0.274) and post-operative stage (0.19±0.31mg/L vs 0.22±0.38mg/L, P=0.08). Rosuvastatin group had a significantly lower incidence of CIAKI compared with that in control group (1.5% vs 3.4%, P<0.01). The 30-day clinical follow-up revealed that, compared between rosuvastatin group and control group, the rate of aggravation of heart dysfunction (2.4% vs 4.2%, P=0.02) and all-cause mortality rate (0.3% vs 0.7%, P=0.04) were significantly different (P<0.05), while the incidence of adverse drug reaction (1.0% vs 1.3%, P=0.71) was not significantly different. CONCLUSION: Rosuvastatin may significantly decrease the risk of CIAKI and cardiovascular events in patients with T2DM and concomitant CKD (stages 2) undergoing arterial contrast media injection. Moreover, it does not increase the excretion of urinary microalbumin.