대한신장학회

논문분류	춘계학술대회 초록집
제목	Preventive Impact and Optimization of Statin Therapy in Patients With Chronic Kidney Disease Admitted to the Intensive Care Unit: A Deep Learning-Based Causal Inference Study
저자	Min Woo Kang
출판정보	2025; 2025(1):
키워드	chronic kidney disease, statin , intensive care unit, deep learning
초록	Statins, commonly used in chronic kidney disease (CKD) patients to manage dyslipidemia and cardiovascular risk, also possess anti-inflammatory and antioxidant properties that may benefit short-term outcomes in the intensive care unit (ICU). However, the effects of statins on short-term complications in critically ill CKD patients are not fully understood. This study utilized data from the Medical Information Mart for Intensive Care (MIMIC)-IV database, focusing on ICU-admitted CKD patients. The treatment variable was defined based on statin use, defined as a recorded statin dose within one day prior to ICU admission. We analyzed outcomes including in-hospital mortality, kidney injury, and prolonged ICU stay, defined as a duration of seven days or more. A deep learning-based causal inference model was used to analyze average treatment effects, and subgroup analyses were conducted. Multivariable logistic regression analysis further examined patient characteristics associated with higher benefits from statin use. Of the 11,745 CKD patients included in the analysis, 55.5% received statin therapy prior to ICU admission. The overall in-hospital mortality rate was 13.4%, and 18.7% experienced kidney outcomes. Statin use was associated with a 3.95% reduction in in-hospital mortality, a 0.75% reduction in kidney injury, and a 0.57% reduction in prolonged ICU stays. Subgroup analyses revealed that statin therapy reduced mortality even in patients without comorbidities that elevate cardiovascular risk. Additionally, patients with lower baseline estimated glomerular filtration rates (eGFR), chronic liver disease, cancer, and septic shock characteristics (e.g., positive blood cultures, vasopressor use, low mean arterial pressure) were associated with higher benefits from statin therapy. Statin therapy administered before ICU admission in CKD patients is associated with reduced risks of in-hospital mortality, kidney injury, and prolonged ICU stays. Certain patient characteristics are associated with even greater benefit from statin use. These findings may support the consideration of expanded statin use in high-risk CKD patients.
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