Cessation of Bezafibrate in patients with chronic kidney disease improves renal function

Sci Rep. 2020 Nov 13;10(1):19768. doi: 10.1038/s41598-020-76861-1.

Abstract

Bezafibrate (BzF) is eliminated by renal excretion and dosage must be reduced in patients with chronic kidney disease (CKD). There is a concern that BzF causes a further deterioration in renal function in patients with CKD. This study assessed whether BzF discontinuation or dose reduction in CKD patients improves renal function. 117 CKD patients treated with BzF between 2009 and 2014 were studied for demographics, comorbid conditions and laboratory variables. Data compared 2 groups: an intervention group of 64 patients where recommendations regarding BzF administration was implemented and a control group of 37 patients. Follow-up was maintained for 12 months. In the intervention group, estimated glomerular filtration rate (eGFR) increased from 38 to 42 mL/min/1.73 m2 (p = 0.01); blood urea levels decreased from 81 to 77 mg/dL (p = 0.04). Serum creatinine decreased by more than 0.2 mg/dL in 45% of the intervention group, as compared to 19% of the control group (p < 0.01). Improvement in eGFR was seen exclusively in patients who stopped BzF completely (eGFR increased from 38 to 44 mL/min/1.73 m2). In the intervention group, TG level increased from 183 to 220 mg/dL (p < 0.001). BzF cessation in approximately 50% of patients with CKD was associated with an increase in eGFR.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bezafibrate / pharmacokinetics*
  • Bezafibrate / therapeutic use*
  • Case-Control Studies
  • Creatine Kinase / blood
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Kidney Function Tests
  • Male
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / metabolism*
  • Retrospective Studies
  • Urea / blood

Substances

  • Urea
  • Creatinine
  • Creatine Kinase
  • Bezafibrate