title: Effect of fenofibrate treatment for hyperlipidaemia on serum creatinine and cystatin C.
abstract: BACKGROUND
  The increase in creatinine in patients on fibrate therapy is well-recognized, but its mechanism is not clearly understood. A study by Hottelart et al. suggested that fibrate-induced creatininaemia was due to the effect of fibrates on creatinine metabolism as opposed to a decline in renal function. To address this hypothesis, we have monitored renal function in a group of hyperlipidaemic patients before commencing fibrate treatment and after three months of therapy.
  
  
  METHODS
  We studied 12 subjects (10 men, 2 women), median age 43.5 y (range 33-70 y). Serum creatinine, cystatin C, creatine kinase and fasting lipids were measured.
  
  
  RESULTS
  We observed statistically significant increases in concentrations of serum creatinine (P < 0.005) and cystatin C(P < 0.01). Concentrations of both analytes increased in 10 (83.3%) of the patients. In these patients, the median increases were 15.1% (range 5.5-23.2%) for creatinine and 9.9% (range 1.1-26.1%) for cystatin C.
  
  
  CONCLUSIONS
  These results suggest that the decrease in estimated glomerular filtration rate, observed in patients undergoing fibrate therapy, is a genuine effect on kidney function rather than a change in creatinine metabolism as previously postulated, since the rises in serum creatinine concentration were reflected by rises in cystatin C, an independent marker of renal function.
authors: Department of Clinical Biochemistry, Frimley Park Hospital NHS Foundation Trust, Frimley, Surrey GUI6 JUJ, UK.
authors: Vusumuzi
authors: V
authors: Ncube
authors: Bryan
authors: B
authors: Starkey
authors: Tim
authors: T
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D011345:Fenofibrate / Q000494:pharmacology / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D055316:Cystatin C; D000960:Hypolipidemic Agents; D003404:Creatinine; D003402:Creatine Kinase; D011345:Fenofibrate