Korean J Med.  2014 Jun;86(6):698-701.

Fenofibrate Therapy and Change of Renal Function: Management, What and How?

• Kim SH

Abstract

Fenofibrate is one of PPAR-alpha (peroxisome proliferator activated receptor alpha) agonists. Fenofibrate decreases effectively triglyceride and increases high density lipoprotein cholesterol level through the effect on lipoprotein lipase, hepatic production and degradation of lipoproteins. Fenofibrate was recommended as the drug for hypertriglyceridemia treatment in European guideline released in 2011. But American heart association guideline in 2013 did not recommend non-statin therapy including fibrate for the prevention of atherosclerotic cardiovascular disease. But fenofibrate is still considered as the important drug for the management of atherogenic dyslipidemia especially in patients with metabolic syndrome and diabetes to reduce the residual risk after statin therapy from the evidence of many studies. Fibrates including bezafibrate, gemfibrozil, and fenofibrate increased serum creatinine level in several studies. But the mechanism of change in renal function is not clear till now. And the reversibility of renal function with drug discontinuation is dependent on the kinds of fibrate. Fenofibrate increased serum creatinine level, decreased albuminuria and renal function was reversible with the drug discontinuation in large clinical trials. In these days renal function change with fenofibrate therapy in Korean patients with hypertriglyceridemia was investigated. Fenofibrate treatment for 2 months increased serum creatinine level significantly and old age was associated with the change of renal function in multivariate analysis. Short-term therapy significantly increased serum creatinine level even within normal range, and this change may be important in some groups especially old age.

Keyword

Fenofibrate; Creatinine; Glomerular filtration rate

MeSH Terms

Albuminuria
American Heart Association
Bezafibrate
Cardiovascular Diseases
Cholesterol, HDL
Creatinine
Dyslipidemias
Fenofibrate*
Fibric Acids
Gemfibrozil
Glomerular Filtration Rate
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypertriglyceridemia
Lipoprotein Lipase
Lipoproteins
Multivariate Analysis
Reference Values
Triglycerides
Bezafibrate
Cholesterol, HDL
Creatinine
Fenofibrate
Fibric Acids
Gemfibrozil
Lipoprotein Lipase
Lipoproteins