Fenofibrate Linked to Lower Creatinine Clearance

Drug may also decrease glomerular filtration rate and increase cystatin C in type 2 diabetes
By Eric Metcalf
HealthDay Reporter

FRIDAY, Feb. 12 (HealthDay News) -- Long-term use of fenofibrate in type 2 diabetes is linked to lowered measures of renal function but has no effect on albumin excretion rate, according to research published in the February issue of Diabetes Care.

Carol Forsblom, of the Folkhalsan Institute of Genetics in Helsinki, Finland, and colleagues analyzed data from 170 subjects with type 2 diabetes participating in a substudy of the Fenofibrate Intervention and Event Lowering in Diabetes study, which found that fenofibrate reduced the progression of microalbuminuria in such patients. Patients were randomized to receive 200 mg of micronized fenofibrate daily or placebo for five years.

The researchers found that plasma creatinine increased in the fenofibrate group, but urine creatinine levels remained similar between the groups. This led to a decline in calculated creatinine clearance and estimated glomerular filtration rate (eGFR) in the treatment group. Cystatin C increased more in the treatment group (14.1 versus 3.6 percent). Albumin excretion rate decreased in both groups and albumin-to-creatinine ratio remained stable.

"Available data do not allow us to conclude whether the fenofibrate-induced increase in creatinine and cystatin C are relevant for the prognoses of these patients, but obviously the changes in the estimates of eGFR impair the follow-up of renal function in clinical practice," the authors write. "Currently, the use of fenofibrate for cardiovascular protection should be considered in the context of the increases of both creatinine and cystatin C."

Two co-authors reported financial relationships with Eli Lilly and/or other pharmaceutical companies.

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