Fenofibrate delays need for dialysis, cuts CV risk in advanced CKD

Use of fenofibrate provides cardiovascular (CV) benefits similar to that of statins and may even delay the need for permanent dialysis in patients with advanced chronic kidney disease (CKD), a study has shown. Moreover, the combination of fenofibrate and high-intensity statins may deliver additional benefits.

The investigators conducted this national cohort study based on Taiwan’s National Health Insurance Research Database to compare outcomes among advanced CKD patients treated with fenofibrate, statins, a combination of both, and none of these.

Patients aged <20 years with advanced CKD were included and further divided into four groups according to treatment: they received fenofibrate, statins, combination therapy, or none in the 3 months preceding the disease. The inverse probability of treatment weighting was used to balance baseline characteristics. Outcomes measured were as follows: CV death, all-cause mortality, and incidence of permanent dialysis.

The risk of CV death was lower in the fenofibrate and statin groups compared with the nonuser group (fenofibrate vs nonuser: hazard ratio [HR], 0.84, 95 percent confidence interval [CI], 0.75–0.94; statins vs nonuser: HR, 0.94, 95 percent CI, 0.90–0.97). Users of fenofibrate also showed the lowest incidence of permanent dialysis (fenofibrate vs nonuser: subdistribution HR, 0.78, 95 percent CI, 0.77–0.80; statins vs fenofibrate: subdistribution HR, 1.27, 95 percent CI, 1.26–1.29; combination vs fenofibrate: subdistribution HR, 1.15, 95 percent CI, 1.13–1.17).

In addition, the combined administration of fenofibrate and high-intensity statins resulted in a reduced risk of major adverse cardiac and cerebrovascular events.