고중성지방혈증 환자에서 단기간의 Fenofibrate 투여가 혈중크레아티닌 농도에 미치는 영향

초록

Background/Aims: Previous studies have reported that fenofibrate therapy increases blood creatinine levels. The aim of this studywas to evaluate the effect of fenofibrate therapy on the renal function in patients with hypertriglyceridemia and to determine theparameters associated with changes in renal functions.Methods: This prospective study enrolled 86 hypertriglyceridemic patients (triglycerides ≥ 200 mg/dL) who were divided into twogroups: the fenofibrate group (n = 43), who received 160 mg of fenofibrate, and the control group (n = 43). Lipid profiles and renalfunction were measured at the beginning of the study and after 2 months.Results: The estimated glomerular filtration rate (eGFR) decreased in the fenofibrate group (p < 0.001), but did not change in thecontrol group (p = 0.80). Accordingly, the decrease was more pronounced in the fenofibrate group than the control group (-18.6 ±8.6 vs. 0.9 ± 9.6%, respectively; p < 0.001). Changes in serum creatinine (p < 0.001) and blood urea nitrogen (p < 0.005) levels weresimilar to those of eGFR. In a stepwise linear regression analysis, the percent change in creatinine was independently associatedwith fenofibrate therapy (r = 0.71; p < 0.001) and old age (r = 0.27; p < 0.05) in all patients. In the fenofibrate group, percent changein creatinine was associated with age (r = -0.51; p < 0.001) and smoking (r = 0.42; p < 0.005), while percent change was associatedwith body mass index (r = 0.31; p < 0.05) in the control group. Elevation of creatinine by 20% or more was associated withfenofibrate therapy (p < 0.001) and old age (p < 0.005) in all patients, and with old age (p < 0.001) in the fenofibrate group.Conclusions: Short-term fenofibrate therapy significantly impaired the renal function of hypertriglyceridemic patients, and thiseffect was more pronounced in elderly patients. This finding suggests that creatinine levels should be followed in patients receivingfenofibrate therapy.

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