Fenofibrate renal failure

Soyoral YU, Canbaz ET, Erdur MF, Emre H, Begenik H, Erkoc R (2012) Fenofibrate -induced rhabdomyolysis in a patient with stage 4 chronic renal failure due to diabetes mellitus. J Pak Med Assoc 62 849-851... 

All fibrates increase the lithogenicity of bile. Clofibrate has been associated with increased risk of gallstone formation gemfibrozil and fenofibrate reportedly do not increase biliary tract disease. Renal failure and hepatic dysfunction are relative contraindications to fibrate therapy. Combined statin-fibrate therapy should be avoided in patients with impaired renal function. Gemfibrozil should be used with caution and at a reduced dosage to treat the hyperlipidemia of renal failure. Fibrates should not be used by children or pregnant women. 

Adverse effects due to fenofibrate use often relate to the skeletal muscle, kidney or liver. A 51-year-old female patient who was on fenofibrate therapy for 2 years developed rhabdomyolysis complicated with acute renal failure after discontinuation of the drug for a short period of time [27]. 

Kiskac M, Zorlu M, Yavuz E. A case of rhabdomyolysis complicated with acute renal failure after resumption of fenofibrate therapy a first report. Indian J Pharmacol 2013 45 305-6. 

Assurance of good renal and hepatic function is mandatory before beginning treatment with the fibrates (22). Serum transaminase changes are regularly seen and hepatitis occurs (23). Several cases of hepatitis due to fenofibrate have been reviewed (24) and it has also been observed with etofibrate (25). One case of liver failure, probably due to beclobrate, has been reported (SEDA-13, 1324 26). Liver biopsies showed a lymphoplasmacytic infiltrate in all of five cases of chronic hepatitis associated with fibrates (27). 

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