Statins and postoperative renal function.

Nowadays statins are a cornerstone in perioperative and long-term cardiovascular risk reduction in vascular surgery patients. As has been strongly advocated by the recent European Society of Cardiology guidelines for perioperative management statins should be prescribed to virtually all patients undergoing vascular surgery. This recommendation has subsequently been reinforced by the results of the DECREASE III trial. The results of this placebo-controlled randomized trial showed a two-fold reduction in perioperative cardiac complications in patients on statins. Though not powered for subgroup analyses there seemed to be no significant difference of effect in open or endovascular treated patients. The study by Moulakakis focusses on a different, less well understood, potential beneficial effect of statins in vascular surgery patients. In this retrospective study patients on statins experienced a significantly lower rate of renal function deterioration compared to patients not on statins when undergoing endovascular abdominal aneurysm repair requiring suprarenal fixation. Data on the potential renal protective effect of statins in patients undergoing EVAR are scarce. However in open vascular surgery large cohort studies have found similar results. Welten et al. studied 1944 patients undergoing open vascular surgery. In this population acute kidney injury, defined as >10% decrease in creatinine clearance, occurred in 664 (34%) patients within 2 days after surgery. Of the 664