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The use of clofibrate in patients with renal insufficiency
Abstract:
Serum clofibrinic acid (CPIB) levels after single and multiple oral doses of clofibrate were studied in 28 patients with elevated serum creatinine values. The half-life of CPIB was prolonged in proportion to the serum creatinine level (r = 0.818 p less than 0.001). Peak CPIB concentrations in serum were not affected by azotemia, although CPIB levels 24 h after a single dose and under steady-state conditions correlated well with the serum creatinine level. The proportion of unbound CPIB was higher in patients with renal insufficiency than in controls (13.9% vs 4.3%), although this difference did not correlate with the serum creatinine level. Hypolipidemic medication is indicated in dyslipoproteinemias associated with renal insufficiency. If a reduced dose is given, clofibrate can be used safely in renal patients, although a CPIB concentration of 70 mg/l in serum should not be exceeded unless the unbound fraction has been measured and found not to exceed a safe level (i.e., 6 mg/l CPIB).
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