Treatment of uremic hypertriglyceridaemia with bezafibrate

Elevated triglycerides (TG) in serum and in very low density lipoproteins (VLDL), and a high cholesterol concentration in VLDL but low concentration in high density lipoproteins (HDL), are some characteristics of chronic, non-nephrotic renal failure (CRF). We have given the clofibrate analogue bezafibrate in a reduced dosage, calculated from individual single dose administrations of bezafibrate, to 12 patients with CRF, to treat their abnormal lipid levels. Serum TG were lowered by 40% due to a decrease in the VLDL fraction by 49%. High levels of LDL cholesterol were lowered, while low levels increased during treatment. HDL cholesterol increased by 17%. Studies of the removal rate of TG-rich particles from the blood and of adipose tissue metabolism could not explain the changes in serum lipids. No subjective or objective side effects from the drug were seen. An individualized dosage of bezafibrate and repeated checks of the serum concentrations of the drug are recommended during long-term treatment of uremic patients.