Fibrate‐induced increase in blood urea and creatinine: is gemfibrozil the only innocuous agent?
Abstract
BACKGROUND: Some reports indicate that fibrates can induce renal dysfunction. However, the clinical characteristics of these episodes, and the respective nephrotoxicity of the four main fibrates used-namely, fenofibrate, bezafibrate, ciprofibrate, and gemfibrozil-remain ill defined. METHODS: To better characterize this side-effect, we first reviewed the charts of 27 patients from our institution who developed an impairment of renal function during fibrate therapy. We next analysed the articles (n=24) that contained data on renal function in patients taking fibrates (n=2676). RESULTS: Among our 27 patients, 25 were on fenofibrate therapy, one was taking bezafibrate, and one ciprofibrate. Nineteen were recipients of solid-organ transplants (kidney recipients, n=15; heart or heart-lung recipients, n=4), and eight were non-transplanted patients with some impairment of renal function. Baseline plasma creatinine ranged from 0.9 to 2.9 mg/dl. It increased by a mean of 40% after the start of fibrate therapy. There was a concomitant increase of blood urea values (mean 36%) in most of the patients. Renal function returned to baseline in 18/24 patients after fibrate discontinuation. However, six patients, all transplant recipients, experienced a permanent increase in plasma creatinine. The incidence of fibrate-induced renal dysfunction among our series of kidney transplant recipients was 60%, as it occurred in 15 of the 25 patients who had ever taken fibrates. An increase of mean creatinine values during therapy was described in all papers on fenofibrate (n=7) and bezafibrate (n=8) (range 8-18% and 8-40% respectively), and in three of four papers dealing with ciprofibrate (range 6-16%). No significant renal impairment was described in any of the eight articles reporting data on gemfibrozil therapy. CONCLUSION: Therapy with fenofibrate, bezafibrate, and ciprofibrate may induce renal dysfunction. Gemfibrozil appears to be devoid of this side-effect.
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Drug-induced elevations in serum creatinine have been reported in those with mild to moderate renal failure and renal transplant recipients.
“Drug-induced elevations in serum creatinine have been reported in those with mild to moderate renal failure (46) and renal transplant recipients (47,48)”
From Effects of Fibrates in Kidney Disease (2012) · cites this paper as [47]
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- Authors
- Broeders, N., Knoop, C., Antoine, M., Tielemans, C., & Abramowicz, D.
- Affiliations
- Erasmus Hospital (BE)
- Venue
- Nephrology Dialysis Transplantation
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-12-01
- Volume
- 15
- Issue
- 12
- Pages
- 1993-1999
- ISSN
- 0931-0509 (ISSN-L)
- 1460-2385
- OpenAlex
- W2099822840
- Cited by
- 163
- References
- 39
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 6 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 6 · 2015: 6 · 2014: 8 · 2013: 7 · 2012: 8
- FWCI
- 5.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nephrology Dialysis Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- fibrates, nephrotoxicity, renal dysfunction, gemfibrozil, fenofibrate, bezafibrate, ciprofibrate, blood urea, serum creatinine, kidney transplant recipients, drug-induced nephrotoxicity
- MeSH terms
- Hypolipidemic Agents, Bezafibrate, Clofibric Acid, Creatinine, Humans, Kidney Diseases, Postoperative Period, Fenofibrate, Retrospective Studies, Urea, Gemfibrozil, Kidney Transplantation, Fibric Acids
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