Researchers at Johns Hopkins may have discovered an
unintended benefit in the drugs millions of Americans take
to lower their cholesterol: The medications, all statins,
seem to lower the risk of a potentially lethal blood
infection known as sepsis in patients on kidney dialysis.
The study is published in the current issue of Journal
of the American Medical Association.
Sepsis is the leading cause of death in noncoronary
intensive care units in the United States, according to the
U.S. Centers for Disease Control. It also poses serious
risk for kidney patients undergoing regular dialysis
The researchers cautioned that kidney dialysis
patients should not necessarily ask their doctors to put
them on statins until more studies are done to verify their
Building on earlier, limited studies that suggested
risk reduction in animals and some people, senior author
Neil R. Powe, professor of medicine and director of the Welch
Center, and his Johns Hopkins team followed 1,041
dialysis patients for 10 years, dividing the subjects into
those taking statins and those not.
Rajesh Gupta, the study's lead author, who was a
senior medical resident at Johns Hopkins when the study was
conducted, said, "Those taking statins had a 41 in 1,000
chance of being hospitalized for sepsis, while the other
group, not taking statins, had a 110 out of 1,000 risk.
Although the overall absolute risk is relatively small, the
statin group's risk is dramatically lower."
Gupta says it remains unclear why or how statins work
this way, "but the consistency of the findings with
laboratory studies adds a lot of credence to the idea that
statins are doing something substantial to reduce risk.
"Statins are known to have an effect on the body's
immune system," he said, "but what that is exactly and how
many statin users it affects are still not widely
Powe said he suspects that statins may regulate the
immune response to infection or may fight microbes
directly. The study's authors said they also suppose that
statins may work like penicillin, since the first statin
was originally derived from a fungus that, it is theorized,
secretes a statin as a way to starve other competing
microorganisms that require cholesterol to survive.
The study included patients from 81 dialysis clinics
across 19 states. Only those enrollees who were admitted to
the hospital with sepsis were counted, in order to rule out
any subjects who became septic during an unrelated hospital
Only 14 percent of those initially enrolled in the
study were on statins. Out of the 1,041 patients, there was
a total of 303 hospitalizations for sepsis.
The study was funded by the National Institute of
Diabetes and Digestive and Kidney Diseases. Other
investigators are Laura C. Plantinga, Nancy E. Fink and
Josef Coresh, all of Johns Hopkins; Michal L. Melamed, of
the Albert Einstein College of Medicine in New York;
Caroline S. Fox, of the National Heart, Lung and Blood
Institute in Framingham, Mass.; and Nathan W. Levin, of the
Renal Research Institute in New York.