{"id":"6a25c42da1e5","type":"article","url":"https://hartvaat.nl/2026/02/01/nierbeschermende-effecten-van-statines-bij-ckd-patienten-in-hong-kong/","title":"Nierbeschermende effecten van statines bij CKD-patiënten in Hong Kong","title_en":"Reno-protective effects of statins among patients with chronic kidney disease in Hong Kong: a target trial emulation.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["apotheker","internist"],"tags":["acuut-hartfalen","anemie-ckd","chronische-nierziekte","clear-outcomes","credence-trial","fidelio-dkd","figaro-dkd","flow-trial","niertransplantatie"],"journal":"EClinicalMedicine","doi":"10.1016/j.eclinm.2026.103798","source_url":"https://doi.org/10.1016/j.eclinm.2026.103798","authors":["Zoey Cho Ting Wong","Franco Wing Tak Cheng","Ivy Lynn Mak","Emily Tsui Yee Tse","Sydney Chi Wai Tang","Ian Chi Kei Wong","Eric Yuk Fai Wan"],"significance":6,"published":"2026-02-01","source_date":"2026-02-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/kdigo-richtlijn-ckd-2024/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"This target trial emulation evaluated the renoprotective effects of statins in CKD patients in Hong Kong, providing real-world evidence for lipid-lowering therapy's role in slowing kidney disease progression.","created":"2026-07-03T10:25:14Z","updated":"2026-07-03T13:24:40Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Veel gerandomiseerde trials missen voldoende power om primaire nieruitkomsten te beoordelen. Deze target trial emulatie onderzocht of statinetherapie een klinisch relevante nierbeschermende werking biedt bij patiënten met chronische nierziekte in Hong Kong.","abstract_original":"BACKGROUND: Many existing randomised controlled trials lack sufficient power to assess primary kidney outcomes. This study aimed to evaluate whether statin therapy offers a clinically meaningful reno-protective effect in patients with chronic kidney disease (CKD). METHODS: In this retrospective cohort study, electronic health records in Hong Kong were extracted to perform sequential target trial emulation. Eligible adults (aged 18+ years) with CKD who met the indication for statin initiation between Jan 1, 2008 and Dec 31, 2017 were included; those with history of estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m2 were excluded. Participants were categorised as statin initiators or non-initiators at each calendar month during inclusion period, where statin initiators were propensity score-matched with non-initiators. Follow-up data were collected for all participants until the occurrence of outcomes, death, loss to follow-up (2 years after last records), or the end of data availability (Dec 31, 2022), whichever occurred first. The hazard ratio (HR) of all-cause mortality, eGFR deterioration (eGFR <15 mL/min/1.73 m2, ≥30% eGFR decline, and ≥50% eGFR decline) and composite outcomes (all-cause mortality, eGFR <15 mL/min/1.73 m2, and ≥50% eGFR decline) was estimated by pooled logistic regression using intention-to-treat (ITT) and per-protocol (PP) approach. FINDINGS: 1,437,014 eligible person-trials were identified (statin initiators n = 30,907; non-initiators n = 1,406,107), from which 30,892 statin initiators and 108,380 non-initiators were included after propensity-score matching. Relative to non-initiators, significant risk reduction was found among statin initiators in all-cause mortality (HR [95% confidence interval (CI)], ITT: 0.97 [0.95-0.98]; PP: 0.91 [0.88-0.93]), progression to eGFR <15 mL/min/1.73 m2 (ITT: 0.91 [0.89-0.93]; PP: 0.77 [0.74-0.80]), ≥50% eGFR decline (ITT: 0.95 [0.93-0.98]; PP: 0.89 [0.84-0.93]), and composite outcomes (ITT: 0.96 [0.94-0.97]; PP: 0.90 [0.88-0.92]). Statin therapy initiation was also associated significantly with reduced risk of ≥30% eGFR decline using PP approach (0.94 [0.92-0.96]). INTERPRETATION: Over a 10-year follow-up period, initiating statin therapy in patients with CKD was associated with a small yet significant decrease in all-cause mortality and a modest reno-protective effect. Future research should aim to clarify the effects of statin intensity, duration, and adherence. FUNDING: National Natural Science Foundation of China."}