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Wider fibrate use urged in mild to moderate CKD
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MikeV
Oct 22, 2012, 10:19:32 AM10/22/12
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Wider fibrate use urged in mild to moderate CKD
OCTOBER 19, 2012
Lisa Nainggolan
Sydney, Australia - A new meta-analysis shows that fibrate therapy improves
lipid profiles and prevents cardiovascular events in people with chronic
kidney disease (CKD), cutting CV deaths by 40% [1]. The findings also show
that despite increasing serum creatinine—a long-known side effect of
fibrates—the drug class caused no harm to the kidneys in the long run and
may even provide some renal benefits, say Dr Min Jun (George Institute for
Global Health, Sydney, Australia) and colleagues in their paper published
online October 17, 2012 in the Journal of the American College of
Cardiology.
"The major finding is the CV benefit," senior author Dr Vlado Perkovic
(George Institute for Global Health) told heartwire. "While fibrates reduce
CV risk by about 9% in the general population, in our study they seem to be
much more potent in people with kidney disease, and this is important." This
is likely because CKD patients typically have high triglycerides and low
levels of HDL, and this is the lipid profile that appears to particularly
benefit from fibrates, he notes.
The major finding is the CV benefit. Fibrates seem to be much more potent in
people with kidney disease, and this is important.
Thus, overall, the results suggest that fibrates could be used more broadly
in patients with mild to moderate CKD to prevent cardiovascular disease, say
the researchers. Perkovic says doctors shouldn't be afraid of using fibrates
in renal patients. Any spike in creatinine seen on starting therapy "will
reverse," he says, and the meta-analysis shows fibrates reduced proteinuria,
so "they may even be protective" for the kidney, he reiterates.
Writing in an accompanying editorial [2], Dr Peter A McCullough (St John
Providence Health System, Warren, MI) and Dr Michael J Di Loreto (St John
Hospital and Medical Center, Detroit, MI) agree. "In general, fibrates are
some of the best-tolerated drugs to treat dyslipidemia, and the paper by Jun
and coworkers supports their use in patients with CKD."
No evidence that fibrates harm the kidney, and they may even protect it
Jun and colleagues explain that cardiovascular disease is the leading cause
of death in patients with CKD. While dyslipidemia is a risk factor for
progressive kidney disease, the tendency for fibrates to cause an acute
elevation of creatinine has resulted in concerns about the safety of this
therapy in this patient population, and there have been conflicting reports
regarding the impact of fibrate therapy on kidney function.
**
http://www.theheart.org/article/1460773.do?utm_medium=email&utm_source=20121022_EN_Heartwire&utm_campaign=newsletter
**
**********************************
OCTOBER 19, 2012
Lisa Nainggolan
Sydney, Australia - A new meta-analysis shows that fibrate therapy improves
lipid profiles and prevents cardiovascular events in people with chronic
kidney disease (CKD), cutting CV deaths by 40% [1]. The findings also show
that despite increasing serum creatinine—a long-known side effect of
fibrates—the drug class caused no harm to the kidneys in the long run and
may even provide some renal benefits, say Dr Min Jun (George Institute for
Global Health, Sydney, Australia) and colleagues in their paper published
online October 17, 2012 in the Journal of the American College of
Cardiology.
"The major finding is the CV benefit," senior author Dr Vlado Perkovic
(George Institute for Global Health) told heartwire. "While fibrates reduce
CV risk by about 9% in the general population, in our study they seem to be
much more potent in people with kidney disease, and this is important." This
is likely because CKD patients typically have high triglycerides and low
levels of HDL, and this is the lipid profile that appears to particularly
benefit from fibrates, he notes.
The major finding is the CV benefit. Fibrates seem to be much more potent in
people with kidney disease, and this is important.
Thus, overall, the results suggest that fibrates could be used more broadly
in patients with mild to moderate CKD to prevent cardiovascular disease, say
the researchers. Perkovic says doctors shouldn't be afraid of using fibrates
in renal patients. Any spike in creatinine seen on starting therapy "will
reverse," he says, and the meta-analysis shows fibrates reduced proteinuria,
so "they may even be protective" for the kidney, he reiterates.
Writing in an accompanying editorial [2], Dr Peter A McCullough (St John
Providence Health System, Warren, MI) and Dr Michael J Di Loreto (St John
Hospital and Medical Center, Detroit, MI) agree. "In general, fibrates are
some of the best-tolerated drugs to treat dyslipidemia, and the paper by Jun
and coworkers supports their use in patients with CKD."
No evidence that fibrates harm the kidney, and they may even protect it
Jun and colleagues explain that cardiovascular disease is the leading cause
of death in patients with CKD. While dyslipidemia is a risk factor for
progressive kidney disease, the tendency for fibrates to cause an acute
elevation of creatinine has resulted in concerns about the safety of this
therapy in this patient population, and there have been conflicting reports
regarding the impact of fibrate therapy on kidney function.
**
http://www.theheart.org/article/1460773.do?utm_medium=email&utm_source=20121022_EN_Heartwire&utm_campaign=newsletter
**
**********************************
Colt T
Oct 22, 2012, 10:32:33 AM10/22/12
to
I think many things may increase serum creatinine which is why I think
the gfr isn't very reliable.
the gfr isn't very reliable.
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