Abstract：
OBJECTIVE: Previous studies have shown that fenofibrate improves outcomes such as albuminuria and estimated glomerular filtration rate decline. We hypothesize that fenofibrate has renoprotective effects and prevents or delays the development of end-stage renal disease. The objective of this study is to investigate the risk of incident end-stage renal disease in relation to fenofibrate treatment in patients who are already taking statins.
METHODS: We performed a nationwide population-based cohort study using data from the Korea National Health Information Database from 2010 to 2017. Among adults using statins, 413 715 fenofibrate users were compared with 413 715 fenofibrate non-users after 1:1 age, sex and triglyceride matching. The endpoint of this study was incident end-stage renal disease.
RESULTS: During a median 3.96-year follow-up, the incidence per 1000 person years of end-stage renal disease was lower in fenofibrate users than in fenofibrate non-users (0.885 vs. 0.960, p < 0.0001). The hazard ratio for end-stage renal disease was lower (0.763, 95% confidence interval 0.710-0.821) in fenofibrate users. This association was significant in patients with hypertension, proteinuria and an estimated glomerular filtration rate <60 mL/min/1.732.
CONCLUSIONS: Fenofibrate use in patients taking statins with either hypertension, proteinuria, or decreased estimated glomerular filtration rate is associated with a low risk of incident end-stage renal disease. To confirm the renoprotective effect of fenofibrate in chronic kidney disease, a randomized controlled trial is warranted.
METHODS: We performed a nationwide population-based cohort study using data from the Korea National Health Information Database from 2010 to 2017. Among adults using statins, 413 715 fenofibrate users were compared with 413 715 fenofibrate non-users after 1:1 age, sex and triglyceride matching. The endpoint of this study was incident end-stage renal disease.
RESULTS: During a median 3.96-year follow-up, the incidence per 1000 person years of end-stage renal disease was lower in fenofibrate users than in fenofibrate non-users (0.885 vs. 0.960, p < 0.0001). The hazard ratio for end-stage renal disease was lower (0.763, 95% confidence interval 0.710-0.821) in fenofibrate users. This association was significant in patients with hypertension, proteinuria and an estimated glomerular filtration rate <60 mL/min/1.732.
CONCLUSIONS: Fenofibrate use in patients taking statins with either hypertension, proteinuria, or decreased estimated glomerular filtration rate is associated with a low risk of incident end-stage renal disease. To confirm the renoprotective effect of fenofibrate in chronic kidney disease, a randomized controlled trial is warranted.
摘要：
目的：先前的研究表明非诺贝特可改善预后，如蛋白尿和估计的肾小球滤过率下降。我们假设非诺贝特具有肾脏保护作用，可以预防或延迟终末期肾脏疾病的发展。这项研究的目的是调查已经服用他汀类药物的患者与非诺贝特治疗相关的终末期肾病的风险。
方法：我们使用2010年至2017年韩国国家健康信息数据库的数据进行了一项基于人群的全国性队列研究。在使用他汀类药物的成年人中，413715非诺贝特使用者与413715非诺贝特非使用者在1:1年龄后进行了比较，性别和甘油三酯匹配。这项研究的终点是终末期肾病。
结果：在平均3.96年的随访中，非诺贝特使用者每1000人年的终末期肾病发病率低于非诺贝特非使用者(0.885vs.0.960，p<0.0001)。非诺贝特使用者的终末期肾病的危险比较低（0.763，95％置信区间0.710-0.821）。这种关联在高血压患者中很重要，蛋白尿和估计的肾小球滤过率<60mL/min/1.732。
结论：非诺贝特用于服用他汀类药物伴高血压的患者，蛋白尿,或估计的肾小球滤过率降低与终末期肾病的低风险相关.为了证实非诺贝特在慢性肾脏病中的肾脏保护作用，随机对照试验是必要的.
方法：我们使用2010年至2017年韩国国家健康信息数据库的数据进行了一项基于人群的全国性队列研究。在使用他汀类药物的成年人中，413715非诺贝特使用者与413715非诺贝特非使用者在1:1年龄后进行了比较，性别和甘油三酯匹配。这项研究的终点是终末期肾病。
结果：在平均3.96年的随访中，非诺贝特使用者每1000人年的终末期肾病发病率低于非诺贝特非使用者(0.885vs.0.960，p<0.0001)。非诺贝特使用者的终末期肾病的危险比较低（0.763，95％置信区间0.710-0.821）。这种关联在高血压患者中很重要，蛋白尿和估计的肾小球滤过率<60mL/min/1.732。
结论：非诺贝特用于服用他汀类药物伴高血压的患者，蛋白尿,或估计的肾小球滤过率降低与终末期肾病的低风险相关.为了证实非诺贝特在慢性肾脏病中的肾脏保护作用，随机对照试验是必要的.
