New Fibrate Use Ups Serum Creatinine Levels in Elderly
(HealthDay News) – For elderly adults, new fibric acid derivative (fibrate) use is associated with an increase in serum creatinine levels, in hospitalizations for these levels, and in nephrologist consultations, according to a study published in the April 17 issue of the Annals of Internal Medicine.
Ying Y. Zhao, MD, from the Yale University School of Medicine in New Haven, CT, and colleagues conducted a population-based cohort study to assess renal outcomes for 19,072 new fibrate users, compared with 61,831 new ezetimibe users, aged ≥66 years. Outcomes were assessed within 90 days of receiving a new prescription for a fibrate or ezetimibe.
The researchers found that fibrate users were significantly more likely to be hospitalized for an increase in serum creatinine level compared with ezetimibe users (adjusted odds ratio [OR], 2.4). They were also more likely to consult a nephrologist (adjusted OR, 1.3; 95% confidence interval, 1–1.6). The risk of all-cause mortality or receiving dialysis for severe acute kidney injury was similar between the groups. In a subpopulation of 220 fibrate users and 890 ezetimibe users, 9.1% and 0.3%, respectively, had a ≥50% increase in serum creatinine levels (OR, 29.6). Fibrate patients with chronic kidney disease experienced increased risks.
"New fibrate use in elderly adults was associated with an increase in serum creatinine level and a small 90-day absolute increase in hospitalizations and nephrologist consultations," the authors write. "The mechanism and clinical significance of the increase in serum creatinine level with fibrates is unclear."
The authors used the Drug Product and Therapeutic Class Database from Brogan Inc.