Effects of Long-Term Fenofibrate Treatment on Markers of Renal Function in Type 2 Diabetes: FIELD Helsinki Substudy. Export

@article{citeulike:6042185, abstract = {Objective. Although fenofibrate was associated with less progression of albuminuria in the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study, it is unknown if it has any effect on renal function. We explored if there were changes in commonly available markers of renal function during fenofibrate treatment in the FIELD Helsinki cohort excluding statin users. Research Design and Methods. 170 subjects with type 2 diabetes were randomly assigned to micronised fenofibrate 200 mg/day or placebo for 5 years. In this substudy, we measured several markers of albumin excretion and renal function. Results. Following intensified treatment, blood pressure and fasting glucose decreased in both groups while HbA(1c) remained at 7.2\%. Plasma creatinine increased with fenofibrate while urine creatinine remained comparable between the groups, resulting in significant decreases in both creatinine clearance and estimated glomerular filtration rates (eGFR) by the MDRD-4 and Cockroft-Gault equations in the fenofibrate group. Cystatin C increased during fenofibrate treatment. Urinary albumin/creatinine ratio and diurnal urine protein remained unchanged, whereas overnight urinary albumin excretion rate showed minor decreases in both groups. Conclusions. We report concomitant decreases in creatinine clearance and eGFR by fenofibrate. These changes complicate the clinical surveillance during fenofibrate treatment. We could not demonstrate beneficial effects of fenofibrate on albumin excretion. A novel finding is increase of cystatin C in type 2 diabetic patients during fenofibrate treatment. The clinical relevance of the changes needs to be assessed in a long-term outcome study of renal function.}, author = {Forsblom, Carol and Hiukka, Anne and Leinonen, Eeva S. and Sundvall, Jouko and Groop, Per-Henrik H. and Taskinen, Marja-Riitta R.}, citeulike-article-id = {6042185}, citeulike-linkout-0 = {http://dx.doi.org/10.2337/dc09-0621}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19846798}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19846798}, day = {21}, doi = {10.2337/dc09-0621}, issn = {1935-5548}, journal = {Diabetes care}, month = {October}, posted-at = {2009-10-30 11:16:08}, priority = {2}, title = {Effects of Long-Term Fenofibrate Treatment on Markers of Renal Function in Type 2 Diabetes: FIELD Helsinki Substudy.}, url = {http://dx.doi.org/10.2337/dc09-0621}, year = {2009} }

TY - JOUR ID - citeulike:6042185 L3 - citeulike-article-id:6042185 N2 - Objective. Although fenofibrate was associated with less progression of albuminuria in the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study, it is unknown if it has any effect on renal function. We explored if there were changes in commonly available markers of renal function during fenofibrate treatment in the FIELD Helsinki cohort excluding statin users. Research Design and Methods. 170 subjects with type 2 diabetes were randomly assigned to micronised fenofibrate 200 mg/day or placebo for 5 years. In this substudy, we measured several markers of albumin excretion and renal function. Results. Following intensified treatment, blood pressure and fasting glucose decreased in both groups while HbA(1c) remained at 7.2%. Plasma creatinine increased with fenofibrate while urine creatinine remained comparable between the groups, resulting in significant decreases in both creatinine clearance and estimated glomerular filtration rates (eGFR) by the MDRD-4 and Cockroft-Gault equations in the fenofibrate group. Cystatin C increased during fenofibrate treatment. Urinary albumin/creatinine ratio and diurnal urine protein remained unchanged, whereas overnight urinary albumin excretion rate showed minor decreases in both groups. Conclusions. We report concomitant decreases in creatinine clearance and eGFR by fenofibrate. These changes complicate the clinical surveillance during fenofibrate treatment. We could not demonstrate beneficial effects of fenofibrate on albumin excretion. A novel finding is increase of cystatin C in type 2 diabetic patients during fenofibrate treatment. The clinical relevance of the changes needs to be assessed in a long-term outcome study of renal function. JF - Diabetes care SN - 1935-5548 TI - Effects of Long-Term Fenofibrate Treatment on Markers of Renal Function in Type 2 Diabetes: FIELD Helsinki Substudy. AU - Forsblom, Carol AU - Hiukka, Anne AU - Leinonen, Eeva AU - Sundvall, Jouko AU - Groop, Per-Henrik AU - Taskinen, Marja-Riitta PY - 2009/10/21/ UR - http://dx.doi.org/10.2337/dc09-0621 ER -