J Lipid Atheroscler.  2017 Dec;6(2):89-96. 10.12997/jla.2017.6.2.89.

Effect of Long-term Fenofibrate Therapy on Serum Creatinine and Its Reversibility in Hypertriglyceridemic Patients with Hypertension

• Park GT
• Jung M
• Kim Y
• Cho I
• Won H
• Shin SY
• Lee WS
• Lee KJ
• Kim SW
• Kim TH
• Kim CJ

• KMID: 2401111
• DOI: http://doi.org/10.12997/jla.2017.6.2.89

Abstract

OBJECTIVE
Previous studies have shown that fenofibrate therapy increases serum creatinine level and that there is a return of serum creatinine to baseline level after the discontinuation of the drug. We evaluated the effect of long-term fenofibrate therapy on creatinine levels and its reversibility in patients with hypertension and hypertriglyceridemia.
METHODS
This retrospective study enrolled 54 hypertensive and hypertriglyceridemic patients taking fenofibrate for 3-6 years (Fenofibrate group) and 30 control patients with similar age, sex, follow-up duration, and creatinine levels (Control group). In 23 patients taking fenofibrate with low triglyceride level and/or with high creatinine levels, fenofibrate was discontinued, and creatinine levels were measured after 2 months.
RESULTS
Creatinine levels increased in both the fenofibrate group (from 0.91±0.18 mg/dL to 1.09±0.23 mg/dL, p < 0.001) and the control group (from 0.94±0.16 mg/dL to 0.98±0.16 mg/dL, p=0.04) compared to baseline. However, the elevation was more pronounced in the fenofibrate group than in the control group (21.1±15.4% vs. 4.5±11.3%, p < 0.001). The discontinuation of fenofibrate lowered creatinine levels (from 1.39±0.32 mg/dL to 1.15±0.24 mg/dL, p < 0.001) which were still higher than pre-treatment levels (p=0.013).
CONCLUSION
Long-term fenofibrate therapy significantly increased creatinine levels in hypertensive and hypertriglyceridemic patients. The effect of fenofibrate on creatinine level was partially reversible. This finding suggests that follow-up creatinine level is necessary with fenofibrate therapy.

Keyword

Fenofibrate; Creatinine; Hypertension; Hypertriglyceridemia; Nephrotoxicity

MeSH Terms

Creatinine*
Fenofibrate*
Follow-Up Studies
Humans
Hypertension*
Hypertriglyceridemia
Retrospective Studies
Triglycerides
Creatinine
Fenofibrate

Figure

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  Fig. 1. Changes in creatinine levels of patients in the fenofibrate group with available levels after medication for 1-3 years (solid) and in the control group (dotted). *; p<0.05 versus baseline levels

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  Fig. 2. Comparisons of creatinine levels at baseline, fenofibrate therapy for 5.4 years, and withdrawal of fenofibrate for 2 months. *; p<0.05 versus baseline levels, **; p<0.05 versus levels after fenofibrate therapy

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