Rosuvastatin is linked to slightly increased risk of kidney failure compared with atorvastatin, underlining the need to start and stay low with patients who have chronic kidney disease, according to US researchers. 

Their study, of nearly a million patients initiating statin therapy, provides solid real-world data on proteinuria, haematuria and kidney failure with rosuvastatin, finding the risk increases in a dose–response manner.

The team, led by Johns Hopkins University, analysed electronic health record data for more than 150,000 new users of rosuvastatin and more than 795,000 new users of atorvastatin from 2011 to 2019. 

Over a median follow-up of three years, the team found that rosuvastatin users had a 15% higher risk of developing kidney failure requiring replacement therapy, such as dialysis or transplantation, than patients taking atorvastatin.