Fenofibrates prevents diabetic retinopathy, new study shows

[Athena]

http://www.medscape.com/viewarticle/815213

MY opthamologist has recently told me about the preventative effects of fenofibrate drug on diabetic retinopathy (studied on Type 2 diabetics). He also advised that fenofibrates has also a anti-neuropathy effect as well as a renal protective effect. The latter is very surprising to hear because my Nephrologists certainly have not recommended this drug to me. In fact, I've been warned about the serum creatinine raising effects of fenofibrates in the past.

I wonder whether anyone else has been on this drug or is currently taking it. The ACE inhibitor also raises serum creatinine levels, which is something I've had to get used to over time. Many drugs it seems can raise our creatinine levels but without really affecting our true kidney function. (It doesn't make them less scary though!)

[MooseMom]

Athena, I don't have diabetes, but I've been taking generic fenofibrate (the brand name of the drug I took is Tricor) since 2004.  Many patients with severe CKD take it as it reduces blood lipid/triglyceride levels which are a side effect of having CKD.  I do have a transplant but still do not have perfect renal function, so I still take fenofibrate.  It has been very, very effective for me.  My blood lipid levels were off the chart back in 2004 but are now perfect.  No one has ever mentioned fenofibrate affecting serum creatinine, but creatinine is just a number, and when taken in isolation can be very misleading. 

I took an ACE inhibitor for many years, again because of how CKD raises BP, but I was taken off it once I was transplanted.  Again, no one mentioned anything about creatinine levels and ACE inhibitors.

[iolaire]

Many patients with severe CKD take it as it reduces blood lipid/triglyceride levels which are a side effect of having CKD.  I do have a transplant but still do not have perfect renal function, so I still take fenofibrate.  It has been very, very effective for me.  My blood lipid levels were off the chart back in 2004 but are now perfect.

Is this something the center checks?  (At DaVita they share the basic lab results things like PTH, Phosphorous etc., via a website but not other lab work. So I never know if they are testing for more.)

[MooseMom]

Iolaire, I was diagnosed with fsgs way back in 1992 when no one knew much about it.  FF to 2004 when I moved back to the US and had to have a physical to get onto my husband's insurance.  That was when it was discovered that my renal function had seriously declined.  My triglycerides were 2500 and my cholesterol was 550, all due to poor function.

I was immediately put on Zocor, Tricor (fenofibrate) and Crestor.  My blood lipids dropped immediately and dramatically.  However, I discovered I was allergic to Crestor (skin rash), so I was switched to pravastatin. 

These levels were checked, along with other things, every 3 months during my 8 years as a pre-dialysis patient.

I've never been on dialysis as I was lucky enough to receive a pre-emptive cadaveric transplant just in the nick of time.

I don't know if a dialysis clinic checks blood lipids on a regular basis, but I would hope so, especially if a dialysis patient is taking statins or other drugs to lower lipid levels.  It is my understanding that high levels go hand in had with severely impaired renal function.

[iolaire]

I don't know if a dialysis clinic checks blood lipids on a regular basis, but I would hope so, especially if a dialysis patient is taking statins or other drugs to lower lipid levels.  It is my understanding that high levels go hand in had with severely impaired renal function.

Thanks do the lipids you talk about = cholesterol or is cholesterol just part of them?  My primary doctor does order the cholesterol check yearly.  (My cholesterol level is low, but also low on the good side, so I need more exercise to get the good cholesterol up.)

[MooseMom]

"Blood lipids" is an umbrella term that is meant to include cholesterol and triglycerides.

http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/ART-20048186

[Athena]

Athena, I don't have diabetes, but I've been taking generic fenofibrate (the brand name of the drug I took is Tricor) since 2004.  Many patients with severe CKD take it as it reduces blood lipid/triglyceride levels which are a side effect of having CKD.  I do have a transplant but still do not have perfect renal function, so I still take fenofibrate.  It has been very, very effective for me.  My blood lipid levels were off the chart back in 2004 but are now perfect.  No one has ever mentioned fenofibrate affecting serum creatinine, but creatinine is just a number, and when taken in isolation can be very misleading. 

I took an ACE inhibitor for many years, again because of how CKD raises BP, but I was taken off it once I was transplanted.  Again, no one mentioned anything about creatinine levels and ACE inhibitors.

Moosemum, thanks so much for sharing your experience with this drug. That is extremely interesting to know that your past and current docs have approved the use of fenofibrates for you when you were in a severe stage of CKD. Both Nephs that I have are extremely reserved about it. I do know for a fact that fenofibrates do raise serum creatinine levels in an artificial way (ie the rise does not reflect an accurate indication of true kidney function). ACE inhibitors have the same effect as well. The reservation must be due to the fact that my serum creatinine levels are one of the key indicators of my kidney function (the other being BUN/Urea). I suppose Nephs don't want to become confused about where a patient may be at so that must be why they're not overly fond of other drugs that can distort this measurement.

When I was quite ill recently, I did show very high trigs for the first time & low HDL. I hope it was just an aberration. But if not, fenofibrates may now be quite necessary for me.

[MooseMom]

Athena, just to make myself clear, it was my neph who prescribed all of my bp meds and cholesterol meds.  I doubt very much that he was confused about how these drugs may affect lab numbers.  Here in the US, it is a given that pre-dialysis patients who have severely impaired renal function have hypertension and high blood lipid levels that need to be treated, so it is usually the nephrologist who prescribes these drugs.  During all of my pre-D years, I never saw my GP; my neph pretty much served as my primary care provider.  I don't understand the idea that a neph in any part of the world would be confused about these drugs, especially as there are many other numbers that, in concert with creatinine, serve as indicators of renal function as you mentioned...BUN, serum potassium and phosphorus, etc.

Anyway, I'm sure you and your team will come to a solution!

[Athena]

Sorry Moosemum, I was just observing the reactions of my own Nephs. I think because I've only ever had high LDL levels, they've only ever spoke to me about the need for statins in the past. Except for one brief comment, fenofibrates have been off the radar until now.

I've learned from you that CKD is strongly associated with high lipids. This is not something I've gleaned from my discussions with docs so thank you so much for identifying this for me. Before CKD became apparent in lab results, my lipids were always on the high side of normal or slightly above normal. I would now say that that was perhaps an early sign of CKD.