Comparative effectiveness of rosuvastatin and atorvastatin in preventing Contrast-Induced Nephropathy (CIN) in patients with Chronic Kidney Disease (CKD).

Abstract

Objective: To compare the efficacy of rosuvastatin and atorvastatin in preventing contrast-induced nephropathy (CIN) in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). Study Design: Randomized Controlled Trial. Setting: Department of Nephrology, Shaikh Zayed Hospital, Lahore. Duration: 26/10/2024 to 26/03/2025. Methods: A total of 150 patients with CKD Stage G3, G4, and G5 were randomly assigned to two equal groups (75 patients each) using an online randomizer. Group A received atorvastatin (80 mg at baseline and daily), and Group B received rosuvastatin (40 mg at baseline and daily). Both medications were administered for three days before PCI and continued for two days after PCI. Results: The study included 60 participants with an average age of 57.15 ± 5.56 years and a mean BMI of 27.69 ± 1.62 kg/m². Baseline creatinine levels were 2.53 ± 1.23 mg/dL, increasing to 2.94 ± 2.03 mg/dL post-procedure. CIN occurred in 13 (21.7%) of participants. Among CIN cases, 8 (61.5%) were in the atorvastatin group, while 5 (38.5%) were in the rosuvastatin group (p = 0.347). CIN was more frequent in CKD Stage 5 patients (84.6%), showing a significant association with CKD stage (p < 0.001). However, diabetes (p = 0.387), hypertension (p = 0.276), BMI (p = 0.139), and smoking (p = 0.321) did not show significant associations with CIN. Conclusion: CIN occurred in 21.7% of the study population, with CKD Stage 5 as the strongest predictor (p < 0.001). No statistically significant difference was observed between atorvastatin and rosuvastatin in preventing CIN (p = 0.347).