Fenofibrate Delays the Need for Dialysis and Reduces Cardiovascular Risk Among Patients With Advanced CKD.
J Clin Endocrinol Metab
; 106(6): 1594-1605, 2021 05 13.
Article
en En
| MEDLINE
| ID: mdl-33677489
ABSTRACT
CONTEXT Fenofibrate provides limited cardiovascular (CV) benefits in the general population; however, little is known about its benefit among advanced chronic kidney disease (CKD) patients. OBJECTIVE:
This study compared outcomes among advanced CKD patients treated with fenofibrate, statins, a combination of both, and none of these.METHODS:
This national cohort study was based on Taiwan's National Health Insurance Research Database. Patients younger than 20 years with advanced CKD were identified and further divided into 4 groups according to treatment. The inverse probability of treatment weighting was used to balance baseline characteristics. Patients received fenofibrate, statins, a combination of fenofibrate and statins, or none of these in the 3 months preceding the advanced CKD date. Main outcome measures included all-cause mortality, CV death, and incidence of permanent dialysis.RESULTS:
The fenofibrate and statin groups exhibited a lower risk of CV death (fenofibrate vs nonuser hazard ratio [HR] 0.84; 95% CI, 0.75-0.94; statins vs nonuser HR 0.94; 95% CI, 0.90-0.97) compared with the nonuser group. The fenofibrate group further exhibited the lowest incidence of permanent dialysis (fenofibrate vs nonuser subdistribution HR [SHR] 0.78; 95% CI, 0.77-0.80; statins vs fenofibrate SHR 1.27; 95% CI, 1.26-1.29; combination vs fenofibrate SHR 1.15; 95% CI, 1.13-1.17). Furthermore, the combined administration of fenofibrate and high-intensity statins exhibited a lower risk of major adverse cardiac and cerebrovascular events.CONCLUSION:
For patients with advanced CKD, continuing fenofibrate may provide a protective effect on CV outcomes equal to that of statins, and it may further delay the need for permanent dialysis. The combination of fenofibrate and high-intensity statins may have additional benefits.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
2_muertes_prematuras_enfermedades_notrasmisibles
/
6_cardiovascular_diseases
/
6_chronic_kidney_disease
Asunto principal:
Fenofibrato
/
Enfermedades Cardiovasculares
/
Insuficiencia Renal Crónica
/
Fallo Renal Crónico
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2021
Tipo del documento:
Article
País de afiliación:
Taiwán