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Fenofibrate Reversibly Increases Serum Creatinine Level in Chronic Kidney Disease Patients by Reducing Glomerular Filtration Rate
並列摘要
BACKGROUND. Fenofibrate is a potent lipid-lowering agent that was found to increase serum creatinine, but the underlying mechanism remains controversial.METHODS. Thirteen hypertriglyceridemic patients, composed of 9 males and 4 females with a mean age of 62 (51-76) presenting with an acute rise of serum creatinine 2 weeks to 6 months after starting fenofibrate (200 nag daily) treatment, were recruited. Other possible causes of acute renal failure were excluded based on clinical judgment. The serum creatinine level, BUN, creatinine clearance calculated using a 24-h urine collection, and estimation of glomerular filtration rate using the Cockroft-Gault formula were obtained on fenofibrate treatment. The same tests were repeated 2 weeks after discontinuing the treatment.RESULTS. The data showed serum creatinine rose from 1.8 (1.3-4.9) mg/dL before the treatment to 3.0 (1.8-5.0) mg/dL (P＜0.05) and BUN from 27 (18-40) to 38 (27-58) mg/dL (P＜0.05) 2 weeks to 6 months after the treatment. After discontinuing fenofibrate, serum creatinine declined from 3.0 (2.0.-4.5) to 2.1 (1.7-4.1) mg/dL (P＜0.05), BUN from 34 (52-26) to 24 (19-39) mg/dL (P＜0.05), Cockroft-Gault estimated GFR increased from 32 (23-49) to 47 (31-65) mL/mm (P＜0.05) and creatinine clearance increased from 37 (25-49) to 54 (39-67) mL/min (P＜0.05). However, daily urine creatinine excretion did not significantly change, from 18.1 (15.1-24.5) to 19.3 (13.2-22.7) mg/kg/day.CONCLUSION. Our study shows fenofibrate reversibly increased the serum creatinine level with simultaneous BUN changes, but there was no change in creatinine production. The results suggest a reduction of glomerular filtration rate is responsible for an elevation of serum creatinine.
延伸閱讀
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