Niacin Decreases Death Risk for Kidney Patients

New research finds that taking niacin could greatly reduce patients’ decline in estimated glomerular filtration rate (eGFR) as well as decreasing the rate of all-cause mortality among this group. 

In an observational study, Elani Streja, PhD, a researcher at the University of California, Irvine Medical Center, and colleagues compared 119,891 U.S. Department of Veterans Affairs patients who were prescribed niacin in the years 2005 and 2006 with 3,233,579 VA patients who were never prescribed niacin. A decline in eGFR was defined as an annual decrease of more than 5 mL/min per 1.73 m².
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While all patients had normal eGFR at baseline, the patients who had taken niacin had a higher body mass index (BMI) that those who hadn’t taken niacin. These patients also had lower high-density-lipoprotein cholesterol levels, higher triglyceride levels, and greater use of ACE inhibitors, angiotensin receptor blockers, and statins. Niacin patients were also older than non-niacin patients, with average ages of 63 and 60, respectively. Niacin patients were less likely to be black, and had more hypertension, diabetes, atherosclerotic cardiovascular disease, and congestive heart failure. Women made up just 8% of each group, which the authors said was “not surprising,” considering this was an older VA patient population.

The authors followed patients for a median period of 7.7 years, finding that a decline in eGFR was less common in niacin patients after adjusting for demographic, laboratory, and clinical variables, comorbidities, and the use of ACE inhibitors, angiotensin receptor blockers, and statins.

“Across all models of adjustment, patients who took niacin had an 11% decreased risk of death,” according to Streja.

While considering the large sample and lengthy follow-up period to be strengths of the study, Streja noted that limitations include the lack of data on niacin prescriptions outside the VA system, previous niacin exposure at baseline, patient adherence to niacin, and lipid levels prior to niacin prescription, in addition to the study’s observational nature and the low number of women participants.

The findings were originally presented at Kidney Week 2014: American Society of Nephrology Meeting, held November 11 - 16 in Philadelphia, Pa.

—Mark McGraw