Abstract Body (Do not enter title and authors here): Rationale: Statins are widely used in renal transplant recipients to optimize the cardiovascular risk and improve the outcomes. However, concerns have emerged regarding the potential role in increasing the risk of new-onset Diabetes after transplantation (NODAT). This meta-analysis examines whether statin therapy influences the risk of NODAT and lipid profile parameters in patients without baseline diabetes.
Hypothesis: We evaluate whether the use of statins in renal transplant recipients is associated with a significantly increased risk of developing new-onset diabetes after transplantation. By systematically synthesizing the available global evidence, we aim to clarify the metabolic impact in this population and provide guidance for post-transplant drug management.
Methods: PubMed, Scopus and Cochrane databases were searched for observational studies that compare the use of Statin to No statin use in kidney transplant recipients and reported the outcomes of (1) New-onset Diabetes After Transplant (NODAT); (2) serum creatinine; (3) serum cholesterol; (4) serum triglycerides. Analysis was made with Cochrane RevMan Version 8.21. A random-effects model was used for outcomes with high heterogenicity and assessed with I2 statistics.
Results: We included 6 studies comprised of 43 471 patients, 24 282 received statin (55.85 %) and 19 189 not statin users (44.14 %). NODAT was comprised of 6 studies (RR 1.89; 95% CI 0.72 to 4.97; p=0.20) and the hazard ratio was comprised of 4 studies (HR 1.31; 95% CI 0.39 to 4.37; p=0.66), serum creatinine (MD -0.01 mg/dL; 95% CI –0.05 to 0.03; p=0.64), serum cholesterol (MD 5.84 mg/dL; 95% CI -4.28 to 15.96; p=0.26). In contrast, the level of serum triglycerides (MD 18.02 mg/dL; 95% CI 4.93 to 31.11; p=0.0.07) showed a significant reduction in level of triglycerides in patients that do not use statin vs. patients with statin use.
Conclusions: This meta-analysis found no significant association between statin therapy and the development of NODAT in renal transplant recipients. These results suggest that statin use does not increase the risk of NODAT in this group. Interestingly, there is a significant reduction in triglyceride levels in patients who do not receive statin therapy, indicating a potential lipid-modulating benefit independent of statin use. Further studies are warranted to explore the mechanisms behind these findings and to define the optimal lipid-lowering strategies in renal transplant recipients.