SynthesisThe Cochrane database of systematic reviews2009
HMG CoA reductase inhibitors (statins) for kidney transplant recipients.
Synthesis in The Cochrane database of systematic reviews, 2009. The graph read 4 numbers from its abstract, feeding 3 cells of the map: it supports the treatment in 1, finds no clear difference in 2. Cited by 17 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Ratios
Point estimates favoured statins in terms of cardiovascular mortality (13 studies: RR 0.68, 95% CI 0.46 to 1.03) and non-fatal cardiovascular events (1 study: RR 0.70, 95% CI 0.48 to 1.01), however the results were not statistically significant.
Compared to placebo, statins did not decrease all-cause mortality (14 studies: RR 1.30, 95% CI 0.54 to 3.12).
Point estimates favoured statins in terms of cardiovascular mortality (13 studies: RR 0.68, 95% CI 0.46 to 1.03) and non-fatal cardiovascular events (1 study: RR 0.70, 95% CI 0.48 to 1.01), however the results were not statistically significant.
Differences
Compared to placebo, the use of statins was associated with a significantly lower end of treatment average total cholesterol (10 studies: MD -42.33 mg/dL (1.26 mmol/L), 95% CI -53.02 to -31.64), LDL cholesterol (10 studies: MD -46.15 mg/dL (1.19 mmol/L), 95% CI -55.97 to -36.33) and triglycerides (10 studies: MD -25.46 mg/dL (0.26 mmol/L), 95% CI -33.95 to 16.9).
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Statins×cardiovascular events
InconclusiveOpen on the map →What to test next →29 readable studies in this cell: 19 favour the treatment, 9 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Statins×all-cause mortality
InconclusiveOpen on the map →What to test next →13 readable studies in this cell: 3 favour the treatment, 8 find no difference, 2 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Statins×lipids
SupportsOpen on the map →What to test next →38 readable studies in this cell: 27 favour the treatment, 5 find no difference, 6 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 6 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Current management of chronic kidney disease in type-2 diabetes-A tiered approach: An overview of the joint Association of British Clinical Diabetologists and UK Kidney Association (ABCD-UKKA) guidelines.Diabetic medicine : a journal of the British Diabetic Association · 2025Guideline
- HMG CoA reductase inhibitors (statins) for kidney transplant recipients.The Cochrane database of systematic reviews · 2014 · on this mapPooled it
- HMG CoA reductase inhibitors (statins) for dialysis patients.The Cochrane database of systematic reviews · 2013 · on this mapPooled it
- European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).International journal of behavioral medicine · 2012Guideline
- Benefits and harms of statin therapy for persons with chronic kidney disease: a systematic review and meta-analysis.Annals of internal medicine · 2012 · on this mapPooled it
- Statin treatment and mortality in bacterial infections--a systematic review and meta-analysis.PloS one · 2010Pooled it
- Biomarker assessment of the immunomodulator effect of atorvastatin in stable renal transplant recipients and hypercholesterolemic patients.Molecular diagnosis & therapy · 2010Trial
- Graft protective effects and donor-specific antibody suppression by CD4Journal of cardiothoracic surgery · 2024Article
- The Seattle Heart Failure Model in Kidney Transplant Recipients.Journal of clinical medicine · 2023Article
- Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation.Annals of transplantation · 2022Article
- Post-Transplantation Diabetes Mellitus.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Review
- Management of endocrino-metabolic dysfunctions after allogeneic hematopoietic stem cell transplantation.Orphanet journal of rare diseases · 2014Review
- A common rejection module (CRM) for acute rejection across multiple organs identifies novel therapeutics for organ transplantation.The Journal of experimental medicine · 2013Article
- Statins in the primary prevention of cardiovascular disease.Nature reviews. Cardiology · 2013 · on this mapReview
- Hyperlipidemia and statin use after allogeneic hematopoietic stem cell transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2012Article
- Evidence-based statin prescription for cardiovascular protection in renal impairment.Clinical and experimental nephrology · 2011Review
- Statins, inflammation and kidney disease.Nature reviews. Nephrology · 2011Review
Corrections and comments
- Updated by
Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
backgroundCardiovascular deaths account for the majority of deaths in kidney transplant recipients and dyslipidaemia contributes significantly to their cardiovascular disease. Statins are widely used in kidney transplant patients given their established benefits in the general population, however evidence favouring their use is lacking.
objectivesTo assess the benefits and harms of statin therapy on mortality and renal outcomes in kidney transplant recipients. SEARCH STRATEGY: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and hand searched reference lists of articles and scientific proceedings. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs comparing statins with placebo, no treatment or other statins in kidney transplant recipients. DATA COLLECTION AND ANALYSIS: Two authors independently assessed study quality and extracted data. Statistical analyses were performed using the random effects model after testing for heterogeneity. Results were expressed as mean difference (MD) for continuous outcomes (lipid parameters) and risk ratio (RR) for dichotomous outcomes (mortality, allograft rejection, liver enzymes, occurrence of rhabdomyolysis and study withdrawal) with 95% confidence intervals (CI). MAIN
resultsSixteen studies (3229 patients) comparing statins versus placebo (15) or another statin (1) were included. Compared to placebo, statins did not decrease all-cause mortality (14 studies: RR 1.30, 95% CI 0.54 to 3.12). Point estimates favoured statins in terms of cardiovascular mortality (13 studies: RR 0.68, 95% CI 0.46 to 1.03) and non-fatal cardiovascular events (1 study: RR 0.70, 95% CI 0.48 to 1.01), however the results were not statistically significant. Compared to placebo, the use of statins was associated with a significantly lower end of treatment average total cholesterol (10 studies: MD -42.33 mg/dL (1.26 mmol/L), 95% CI -53.02 to -31.64), LDL cholesterol (10 studies: MD -46.15 mg/dL (1.19 mmol/L), 95% CI -55.97 to -36.33) and triglycerides (10 studies: MD -25.46 mg/dL (0.26 mmol/L), 95% CI -33.95 to 16.9). There was no significant difference in the risk of acute rejection (5 studies: RR 0.61; 95% C.I.0.32 to 1.16.) No data on chronic rejection was available and no major toxicity was noted. AUTHORS'
conclusionsStatins significantly reduced hyperlipidaemia and tended to reduce cardiovascular events in kidney transplant recipients, but no effect has yet been demonstrated for mortality outcomes. Most of the data was derived from one large long-term study. Considering the significant impact of statins on all-cause and cardiovascular mortality in the general and predialysis populations, more studies are needed in kidney transplant patients.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.