Monday, April 08, 2013

Statins rot your kidneys

Allegedly it is only "high dose" statins that do that but that is dubious comfort.  Journal article below
Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administrative databases


Objective: To quantify an association between acute kidney injury and use of high potency statins versus low potency statins.

Design: Retrospective observational analysis of administrative databases, using nine population based cohort studies and meta-analysis. We performed as treated analyses in each database with a nested case-control design. Rate ratios for different durations of current and past statin exposure to high potency or low potency statins were estimated using conditional logistic regression. Ratios were adjusted for confounding by high dimensional propensity scores. Meta-analytic methods estimated overall effects across participating sites.

Setting: Seven Canadian provinces and two databases in the United Kingdom and the United States.

Participants: 2,067,639 patients aged 40 years or older and newly treated with statins between 1 January 1997 and 30 April 2008. Each person hospitalized for acute kidney injury was matched with ten controls.

Intervention: A dispensing event was new if no cholesterol lowering drug or niacin prescription was dispensed in the previous year. High potency statin treatment was defined as ~10 mg rosuvastatin, ~20 mg atorvastatin, and ~40 mg simvastatin; all other statin treatments were defined as low potency. Statin potency groups were further divided into cohorts with or without chronic kidney disease.

Main outcome measure: Relative hospitalization rates for acute kidney injury.

Results: Of more than two million statin users (2,008,003 with non-chronic kidney disease; 59?636 with chronic kidney disease), patients with similar propensity scores were comparable on measured characteristics. Within 120 days of current treatment, there were 4691 hospitalizations for acute kidney injury in patients with non-chronic kidney injury, and 1896 hospitalizations in those with chronic kidney injury. In patients with non-chronic kidney disease, current users of high potency statins were 34% more likely to be hospitalized with acute kidney injury within 120 days after starting treatment (fixed effect rate ratio 1.34, 95% confidence interval 1.25 to 1.43). Users of high potency statins with chronic kidney disease did not have as large an increase in admission rate (1.10, 0.99 to 1.23). ?2 tests for heterogeneity confirmed that the observed association was robust across participating sites.

Conclusions: Use of high potency statins is associated with an increased rate of diagnosis for acute kidney injury in hospital admissions compared with low potency statins. The effect seems to be strongest in the first 120 days after initiation of statin treatment.


Bumptious Susan is "worried" again

She doesn't bother us with any facts, findings or data, of course.  Just her opinion is supposed to carry the day.  The Royal Society booted her out because they got tired of her ego but she has popped up again peddling claims that some people like to hear

Susan Greenfield

Facebook is going to be in your face even more than before. The arrival of the `Facebook Phone' and the eventual availability of the latest it has to offer on all Android platforms, means the current obsession with monitoring the lives of others and recording every moment of your own existence, will be made even easier, a default adjunct to daily life. Whilst the ethics and risk of the possible collation of the ensuing Tsunami of personal information now flooding into the central Facebook databases might raise obvious concerns, as a neuroscientist I'm most worried by what this latest `advance' will mean to us as individuals.

Humans occupy more ecological niches than any other species on the planet because of the superlative ability of our brains, compared with those of any other animal, to adapt to the environment: a process known as `plasticity'. So if the human brain will adapt to whatever environment in which it is placed, an environment where you are constantly on the alert to the actions and views of others, will surely be changing your mindset in correspondingly new ways. How will the 21st Century human brain, with its clear evolutionary mandate, react to this latest development in what has been dubbed `The Digital Wildfire'?

Already privacy appears to be a less prized commodity among the younger generation of `Digital Natives': apparently 55 per cent of teenagers have given out personal information to someone they don't know, including photos and physical descriptions. Meanwhile over half send out group messages to typically over 500 `friends' at a time, fully aware that each of these friends could then pass on that information to their network of further hundreds... It has become more important to have attention, to be `famous'. The trade-off for such disclosure and indeed fame is, and always has been, loss of privacy. So why have we previously treasured privacy so much, but now are holding it in increasing disregard?

Perhaps because until now, privacy has been the other side of the coin to our identity. We have seen ourselves as individual entities, in contact with the outside world for sure, but at the same time always distinct from it. We have interacted with that outside world, but only in the way and at the times we have chosen. You have secrets, memories and hopes to which no one else has automatic access; a private life, distinct from a professional one, as well as a multifaceted one of individual friendships where we vary what and how much we confide in someone else. Above all you have an inner narrative, an ongoing thought process that is yours alone: until now.

Another new feature of `Facebook Home' will be `Chat Heads', which means that when anyone contacts you on your mobile, a little `bubble' featuring a picture of that person will appear with the text. These illustrated `bubbles' will appear on the mobile screen, no matter what you are currently doing on your phone, allowing constant maintained `illustrated' contact. But if you're anchored increasingly in the present, consequently constantly catering for and to the demands of the outside world, that inner narrative might be now even harder to sustain. The mind might remain more child-like, reactive and dependent on the behavior and thoughts of others.

Already we are seeing a generation of 20-somethings still living at home, wearing `onesies' (all in one crawler suits usually reserved for very small infants), perhaps playing mythical or sci-fi games with simplified values of all-good or all-evil, and/or craving the constant attention of others through social networking sites. The `you' externally constructed by Facebook, accentuated further by the latest operating system, may not allow much time and opportunity for internal memories to mature, nor private reflections to develop into a fully-fledged, individual mind. But if you now define yourself externally by the instant thumbs-up from others, then abolition of privacy is to be welcomed in order to belong, and for a new type of identity to flourish - one that is hyper-connected and collective.

Perhaps it will mean living a life where the thrill of reporting and the receiving completely trumps the ongoing experience itself. Your identity now is paradoxically online moment-to-moment but essentially offline in how you register it. The momentary excitements you're feeling are generated not by raw, first-hand life itself, but by the slightly delayed, indirect experience of the continuing reaction and approval of everyone else.

If we're going to be living in a world where face-to-face interaction, unpractised as it is, becomes uncomfortable, then such an aversion to real life, three-dimensional communication combined with a more collective identity, may be changing the very nature of personal relationships themselves. The speed required for reaction and the reduced time for reflection might mean that those reactions and evaluations themselves are becoming increasingly superficial.

It is important to bear in mind that the interaction between the brain and the environment is a two-way dialogue: just as important as how we view and use the latest technology, is the impact that an environment dominated by wizardry such as `Facebook Home' will have on shaping our minds - and hence most significantly, on how we view ourselves.


1 comment:

Olaf Koenders said...

I always liked Susan as a neuroscientist, but I'm still largely unaware of her dealings outside her documentaries.

The main problem is the sheer addictability of BookFace et. al. Likely the reason being that the VAST number of "friends" they have on BookFace, they've never met and don't know where they live. So they can happily stroke their pathetic egos while flaming others.

It's difficult to carry out a face to face conversation with these twerps when they immediately ignore you the nanosecond their phone farts.

The last time a workmate did that to me when I met him at the shopping centre, I just walked off.

Certain members of my family-in-law will switch the TV over to the cricket - much to my annoyance as I was immersed in a doco about geology - and promptly stare blankly into their phones and BookFace, rarely even looking up at the telly again.

That's addiction in the information age. The moment they lose their phone for a few seconds the entire planet has to grind to a halt or have to backtrack as many miles as necessary until this insipid little box is once again firmly attached to their thumbs.

Lose the credit card however, who cares?