New Fibrate Use and Risk for Renal Insufficiency

In several studies, new use of fibrates has been associated with elevated risk for renal insufficiency. Canadian researchers have examined this association in 20,000 older people (age, ≥66) with new prescriptions for fenofibrate. The primary outcome at 90 days was hospitalization for an increase in serum creatinine level. Controls were 62,000 older patients with new prescriptions for ezetimibe, which has no known acute renal effects.

Compared with ezetimibe users, fibrate users had a doubled risk of hospitalization for a rising serum creatinine level (0.4% vs 0.2%). Among 1110 patients for whom serial serum creatinine measurements were available, 9.1% of fibrate users and 0.3% of ezetimibe users had increases in serum creatinine of ≥50%. Pat…