title: Fenofibrate increases serum creatinine in a patient with familial nephropathy associated to hyperuricemia.
abstract: BACKGROUND
  Kidney function progressively deteriorates in patients with familial juvenile hyperuricemiac nephropathy (FJHN, OMIN 162000) and chronic renal disease is commonly associated to dyslipidemia. We report for the first time abrupt renal insufficiency in a patient with FJHN and hypertrygliceridemia following fenofibrate administration.
  
  
  METHODS
  A 53-year-old man was diagnosed clinically with FJHN at age 24 years which was subsequently confirmed by genotypic analysis of the UMOD gene at age 40 years. His mother and two brothers suffered the disease. At that time, renal size and function were normal, as was his blood pressure and serum lipids. At age 34 years, serum urate was 8.5 mg/dL and creatinine 1.7 mg/dL (GFR, 58 mL/min/1.73 m2). He was treated with allopurinol, losartan, and lovastatin. Serum TG levels ranged between 150 and 250 mg/dL. At age 52 years, serum urate was 4.1 mg/dL, creatinine 3.2 mg/dL, LDLc 99 mg/dL (atorvastatin 40 mg/d), and TG 275 mg/dL. Fenofibrate (160 mg/d) was added. One month later, serum creatinine increased to 4.2 mg/dL and TG decreased to 125 mg/dL. He did not complain of muscle pain, weakness, or changes in urinary frequency or color and rabdomyolysis was discarded. Fenofibrate was withheld and three months later serum creatinine decreased to baseline levels (3.2 mg/dL) and TG increased to 197 mg/dL.
  
  
  CONCLUSIONS
  To our knowledge, this is the first patient with FJHN in whom fenofibrate administration was associated to a further impairment in renal function not attributable to rabdomyolysis.
authors.affiliation: a Division of Internal Medicine, Metabolic-Vascular Unit , La Paz University Hospital , IdiPaz , Madrid , Spain.
authors.forename: G
authors.initials: G
authors.lastname: Salgueiro
authors.forename: L M
authors.initials: LM
authors.lastname: Beltrán
authors.forename: R J
authors.initials: RJ
authors.lastname: Torres
authors.forename: J G
authors.initials: JG
authors.lastname: Puig
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood*; D005260:Female; D011345:Fenofibrate / Q000009:adverse effects* / Q000627:therapeutic use; D006073:Gout / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications / Q000188:drug therapy; D033461:Hyperuricemia / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D003404:Creatinine; D011345:Fenofibrate
keywords: Gout; fenofibrate; hypeuricemia