Fenofibrate Therapy Slows CKD Progression in Diabetics

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In a study of patients with type 2 diabetes, researchers observed a significantly lower annual decline in estimated glomerular filtration rate among those treated with fenofibrates vs placebo.
In a study of patients with type 2 diabetes, researchers observed a significantly lower annual decline in estimated glomerular filtration rate among those treated with fenofibrates vs placebo.
The following article is part of conference coverage from the NKF 2018 Spring Clinical Meetings in Austin hosted by the National Kidney Foundation. Renal & Urology News staff will be reporting on medical studies conducted by nephrologists and other specialists who are tops in their field in chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from NKF 2018.

AUSTIN, Texas—Fenofibrate therapy is associated with slower progression of chronic kidney disease (CKD) in patients with type 2 diabetes, according to study findings presented at the National Kidney Foundation's 2018 Spring Clinical Meetings.

In a post-hoc analysis of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial, a team led by Tamara Isakova, MD, MMSc, of Northwestern University Feinberg School of Medicine in Chicago, found that fenofibrate therapy was associated with less rapid decline in estimated glomerular filtration rate (eGFR) and incident micro- and macroalbuminuria compared with placebo among patients with CKD and type 2 diabetes.

In a fully adjusted model, eGFR declined annually by a mean 0.28 mL/min/1.73 m2 among fenofibrate-treated patients compared with an annual mean decline of 1.25 mL/min/1.73 m2 among placebo recipients.

In addition, compared with the placebo arm, the fenofibrate-treated patients had a significant 46% and 28% decreased risk of developing microalbuminuria and macroalbuminuria, respectively, in a fully adjusted model. Investigators observed no significant difference between the placebo and fenofibrate arms with regard to incident CKD and kidney failure.

Dr Isakova's team included in their analysis 5,268 ACCORD participants: 2636 in the fenofibrate arm and 2632 in the placebo arm. They defined microalbuminuria as urinary albumin excretion of 30 to 299 mg per day and macroalbuminuria as urinary albumin excretion of 300 mg or more per day.

To be included in the ACCORD trial, patients needed to have type 2 diabetes for more than 3 months and a hemoglobin A1c percentage of 7.5% or higher.

See more coverage from the National Kidney Foundation Spring Clinical meeting

Reference

Frazier R, Mehta R, Cai X, et al. Associations of fenofibrate therapy with incidence and progression of chronic kidney disease in patients with type 2 diabetes. Data presented at the National Kidney Foundation's 2018 Spring Clinical Meetings in Austin, Texas, April 10-14. Poster 251.

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