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Abstract: TH-PO853

Association of Fibrate Therapy and Incident CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Tran, Diana, University of California Irvine Medical Center, Orange, California, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Whitecavage, Shaun M., University of California Irvine Medical Center, Orange, California, United States
  • Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Thomas, Fridtjof, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine Medical Center, Orange, California, United States
  • Streja, Elani, University of California Irvine Medical Center, Orange, California, United States
Background

Fibrate therapy can result in an acute increase in serum creatinine, which makes the assessment of kidney outcomes associated with fibrates difficult in studies with short follow-up times. We aimed to examine the association of fibrate therapy with incident CKD in a large national cohort of US Veterans with long follow-up.

Methods

In a nationwide cohort of 688,382 US Veterans with an eGFR ≥60 mL/min/1.73m2 and available data on albuminuria in 2004-2006, we examined the association of de novo prescription of fibrate medications during the baseline period with incident CKD (defined as an eGFR <60 mL/min/1.73m2 measured at least twice and separated by at least 90 days) over 14 years. Associations were examined in hazard models adjusted for demographics, major comorbidities, labs, baseline eGFR, and albuminuria.

Results

We identified 58,773 incident new fibrate users. Overall mean (SD) age was 59 (13) years, with 6.6% female, 17.9% Black, and 7.0% Hispanic. Fibrate users were more likely to be male, White, current smokers, and had higher frequencies of comorbidities. There were 139,360 cases of incident CKD (event rate 2.64/100PY, 95% CI: 2.63-2.66) with median follow-up of 8.5 years. Fibrate use (vs. non-use) was associated with higher risk of incident CKD in crude (HR: 1.52, 95% CI: 1.50-1.55, model 1; Figure) and in multivariable adjusted models (HR: 1.33, 95% CI: 1.31-1.36, model 5).

Conclusion

In this large national cohort of US Veterans with long follow-up time, fibrate therapy was associated with a higher risk of incident CKD. Further studies are needed to corroborate these findings by examining alternative kidney end points.

Funding

  • NIDDK Support