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Fenofibrate Delays the Need for Dialysis and Reduces Cardiovascular Risk Among Patients With Advanced CKD

Chieh-Li Yen1,2, Pei-Chun Fan1,2, Ming-Shyan Lin3

  • 1Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.

The Journal of Clinical Endocrinology and Metabolism
|March 7, 2021
PubMed

Insights

Fenofibrate may protect advanced chronic kidney disease (CKD) patients from cardiovascular death, similar to statins. It also appears to delay permanent dialysis, with combination therapy offering additional benefits.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Fenofibrate offers limited cardiovascular (CV) benefits in the general population.
  • Benefits of fenofibrate in advanced chronic kidney disease (CKD) patients are not well-established.

Purpose of the Study:

  • To compare cardiovascular outcomes in advanced CKD patients treated with fenofibrate, statins, both, or neither.
  • To evaluate the impact of these treatments on all-cause mortality, CV death, and the need for permanent dialysis.

Main Methods:

  • National cohort study using Taiwan's National Health Insurance Research Database.
  • Identified patients younger than 20 years with advanced CKD, divided into four treatment groups.
  • Utilized inverse probability of treatment weighting to balance baseline characteristics.

Main Results:

  • Fenofibrate and statin groups showed reduced risk of CV death compared to nonusers.
  • Fenofibrate group had the lowest incidence of permanent dialysis.
  • Combination therapy with fenofibrate and high-intensity statins reduced major adverse cardiac and cerebrovascular events.

Conclusions:

  • Fenofibrate may offer protective CV effects in advanced CKD patients, comparable to statins.
  • Fenofibrate treatment may delay the need for permanent dialysis.
  • Combined fenofibrate and high-intensity statin therapy may provide additional cardiovascular benefits.
Abstract

Keywords:
CVDESRDchronic kidney diseasedyslipidemiafenofibratestatins

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