Kidney Week

Abstract: TH-PO1068

Association of Fibrate Use with Greater Survival Independent of Baseline Kidney Function and Albuminuria

Session Information

• CKD: Therapeutic Advances
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Takahashi, Rina, The Lundquist Institute, Torrance, California, United States

Rina Takahashi

• Shen, Jenny I., The Lundquist Institute, Torrance, California, United States

Jenny I. Shen, MD, MS, FASN

• Tran, Diana, The Lundquist Institute, Torrance, California, United States

Diana Tran, MPH

• Elali, Ibrahim, The Lundquist Institute, Torrance, California, United States

Ibrahim Elali, MD

• Dai, Tiane, The Lundquist Institute, Torrance, California, United States

Tiane Dai, MD, PhD

• Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Keiichi Sumida, MD, PhD, MPH, FASN

• Thomas, Fridtjof, The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Fridtjof Thomas, PhD

• Rhee, Connie, University of California Los Angeles, Los Angeles, California, United States

Connie Rhee, MD, MS

• Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy, MD, FASN

• Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

Background

Fibrate use can result in an acute increase in serum creatinine, making assessing long-term outcomes associated with fibrates difficult. Additionally, some studies reported no change, and others showed improved mortality with fibrate use. This study aims to examine the association of fibrate use with death independent of changes in serum creatinine levels in a large national cohort of United States (US) Veterans with long follow-ups.

Methods

A retrospective cohort study was conducted to examine the association of de novo prescription of fibrate medications during the baseline period with death over 14 years. Patients (n=688,382) were selected from Veterans Administration (VA) research databases if they had data on albuminuria from 2004 to 2006. Associations were examined in Cox proportional hazard models adjusted for demographics, major comorbidities, and laboratory data, including baseline estimated glomerular filtration rate (eGFR), albuminuria, and medications.

Results

We identified 58,773 incident new fibrate users. The overall mean (SD) age was 59 (13) years, with 6.6% female, 17.9% Black, and 7.0% Hispanic, and baseline triglycerides of 119 (81, 181) mg/dl (users 334 (228, 497), non-users 112 (79, 163)) mg/dl. Fibrate users were more likely to be male, White, current smokers, and had higher frequencies of comorbidities. Fibrate use (vs. non-use) was associated with a lower risk of death (Hazard ratio (HR): 0.91, 95% confidential interval [CI]: 0.89-0.93).

Conclusion

In this large national cohort of US Veterans with long follow-up, fibrate use was associated with a lower risk of death independent of baseline renal function and albuminuria. Further studies are needed to corroborate the potential benefits of fibrate on survival.

Funding

• Veterans Affairs Support