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Nephrol Dial Transplant (2001) 16: 1515
© 2001 European Renal Association-European Dialysis and Transplant Association

Letters

Fibrate-induced increase in blood urea and creatinine

J. Lipscombe and J. M. Bargman

Department of Nephrology, University Health Network, Toronto, Canada

Sir,

Broeders et al. [1] describe 27 patients who develop renal dysfunction when treated with a fibric acid derivative. The specific agents used were fenofibrate, bezafibrate, and ciprofibrate. None of the patients were treated with gemfibrozil. Additionally, they reviewed eight articles, none of which showed an increase in creatinine with gemfibrozil treatment. We have observed a similar finding of a deterioration in renal function in 10 patients treated with fibric acid derivatives for hyperlipidaemia [2]. Some of these patients were rechallenged with another or the same fibric acid derivative for a total of 17 treatment courses. In contrast to the findings of Broeders et al., three out of a total of 17 treatment courses which resulted in deterioration in renal function involved the use of gemfibrozil. Although this is a small number of observations, we suggest that gemfibrozil may not be exempt from the potential negative effects on renal function observed with other fibric acid derivatives and that, as with other agents in this class, vigilance and monitoring is warranted with its use in patients with pre-existing renal impairment.

References

  1. Broeders N, Knoop C, Antoine M, Tielemans C, Abramowicz D. Fibrate-induced increase in blood urea and creatinine: is gemfibrozil the only innocuous agent? Nephrol Dial Transplant2000; 15: 1993–1999[Abstract/Free Full Text]
  2. Lipscombe J, Lewis GF, Cattran D, Bargman JM. Deterioration in renal function associated with fibrate therapy. Clin Nephrol2001; 55: 39–44[Web of Science][Medline]

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 Nephrol Dial TransplantHome page
V. Tsimihodimos, E. Bairaktari, M. Elisaf, J. M. Bargman, and J. Lipscombe
Fibrate-induced increase in serum urea and creatinine levels
Nephrol. Dial. Transplant., April 1, 2002; 17(4): 682 - 682.
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