Fenofibrate 투여와 신장 기능의 변화: 무엇을 어떻게 고려해야 할까
Fenofibrate Therapy and Change of Renal Function: Management, What and How?
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Fenofibrate is one of PPAR-α (peroxisome proliferator activated receptor alpha) agonists. Fenofibrate decreases effectively triglycerideand increases high density lipoprotein cholesterol level through the effect on lipoprotein lipase, hepatic production anddegradation of lipoproteins. Fenofibrate was recommended as the drug for hypertriglyceridemia treatment in European guideline releasedin 2011. But American heart association guideline in 2013 did not recommend non-statin therapy including fibrate for theprevention of atherosclerotic cardiovascular disease. But fenofibrate is still considered as the important drug for the management ofatherogenic dyslipidemia especially in patients with metabolic syndrome and diabetes to reduce the residual risk after statin therapyfrom the evidence of many studies. Fibrates including bezafibrate, gemfibrozil, and fenofibrate increased serum creatinine level inseveral studies. But the mechanism of change in renal function is not clear till now. And the reversibility of renal function with drugdiscontinuation is dependent on the kinds of fibrate. Fenofibrate increased serum creatinine level, decreased albuminuria and renalfunction was reversible with the drug discontinuation in large clinical trials. In these days renal function change with fenofibratetherapy in Korean patients with hypertriglyceridemia was investigated. Fenofibrate treatment for 2 months increased serum creatininelevel significantly and old age was associated with the change of renal function in multivariate analysis. Short-term therapysignificantly increased serum creatinine level even within normal range, and this change may be important in some groups especiallyold age.
Abstract
Fenofibrate is one of PPAR-α (peroxisome proliferator activated receptor alpha) agonists. Fenofibrate decreases effectively triglycerideand increases high density lipoprotein cholesterol level through the effect on lipoprotein lipase, hepatic production anddegradation of lipoproteins. Fenofibrate was recommended as the drug for hypertriglyceridemia treatment in European guideline releasedin 2011. But American heart association guideline in 2013 did not recommend non-statin therapy including fibrate for theprevention of atherosclerotic cardiovascular disease. But fenofibrate is still considered as the important drug for the management ofatherogenic dyslipidemia especially in patients with metabolic syndrome and diabetes to reduce the residual risk after statin therapyfrom the evidence of many studies. Fibrates including bezafibrate, gemfibrozil, and fenofibrate increased serum creatinine level inseveral studies. But the mechanism of change in renal function is not clear till now. And the reversibility of renal function with drugdiscontinuation is dependent on the kinds of fibrate. Fenofibrate increased serum creatinine level, decreased albuminuria and renalfunction was reversible with the drug discontinuation in large clinical trials. In these days renal function change with fenofibratetherapy in Korean patients with hypertriglyceridemia was investigated. Fenofibrate treatment for 2 months increased serum creatininelevel significantly and old age was associated with the change of renal function in multivariate analysis. Short-term therapysignificantly increased serum creatinine level even within normal range, and this change may be important in some groups especiallyold age.
참고문헌 (10)
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