Abstract: TH-PO1070
Examining the Associations between Incident Niacin Therapy and Kidney Outcomes
Session Information
- CKD: Therapeutic Advances
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Takahashi, Rina, The Lundquist Institute, Torrance, California, United States
- Bui, Thuy-Anh, University of California Irvine, Irvine, California, United States
- Elali, Ibrahim, The Lundquist Institute, Torrance, California, United States
- Tran, Diana, The Lundquist Institute, Torrance, California, United States
- Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Thomas, Fridtjof, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Dukkipati, Ramanath B., The Lundquist Institute, Torrance, California, United States
- Shah, Anuja P., The Lundquist Institute, Torrance, California, United States
- Rhee, Connie, University of California Los Angeles, Los Angeles, California, United States
- Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States
Background
Despite the favorable data shown in studies of niacin, a lipid-lowering medication that can lower triglycerides and improve other risk factors for renal outcomes, its effect on long-term outcomes remains to be determined. This study aims to examine the associations of niacin therapy with incident chronic kidney disease (CKD) and end-stage renal disease (ESRD) in patients with normal renal function.
Methods
In a nationwide historical cohort of 1,139,630 US Veterans with normal baseline eGFR, we examined the association of de novo prescription of niacin from 2004 to 2006 with incident CKD (defined as eGFR <60 ml/min/1.73m2 on two occasions, separated by ≥90 days) and ESRD during the 14-year follow-up. Associations were examined in Cox proportional hazard models adjusted for demographics, major comorbidities, and laboratory measurements. Prescription time-distribution matching was used to control for survival bias.
Results
We identified 133,450 new users of niacin. Overall, patients (n=1,139,630) had a mean (standard deviation; SD) age of 60 (13) years, with 6% female, 78% White, 16% Black, and 6% Hispanic. Niacin users were more likely to be male, White, current, or former smokers, with higher frequencies of comorbidities. Niacin use (vs. non-use) was associated with a higher risk of CKD (Hazard ratio [HR]: 1.16, 95% confidential interval [CI]: 1.15-1.17) but a lower risk of ESRD (HR: 0.85, 95% CI: 0.79-0.92).
Conclusion
In a large national cohort of US Veterans with normal kidney function, niacin use was associated with a higher risk of incident CKD but a lower risk of ESRD. Additional studies are warranted to examine the potential effect of niacin on renal function.
Funding
- Veterans Affairs Support