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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EResults from a substudy of Fenofibrate Intervention and Event Lowering in Diabetes [FIELD] study, the largest study of fibrates to date, showed no evidence for direct nephroprotection from fenofibrate use [The Field Study Investigators \u003Cem\u003ELancet\u003C\/em\u003E 2005]. There was, however, an increase in plasma creatinine.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes \u0026amp; kidney disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Erenal disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes \u0026amp; endocrinology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EResults from a substudy of FIELD (Fenofibrate Intervention and Event Lowering in Diabetes), the largest study of fibrates to date, showed no evidence for direct nephroprotection from fenofibrate use [The Field Study Investigators. \u003Cem\u003ELancet\u003C\/em\u003E 2005]. There was, however, an increase in plasma creatinine, according to Anne Hiukka, MD, Helsinki University Central Hospital and Biomedicum, Finland.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EFIELD included nearly 10,000 type 2 diabetes patients randomly assigned to fenofibrate 200 mg or placebo for 5 years. It showed no reduction in coronary heart disease events for fenofibrate, but did show some promise in spot samples of urinary albumin\/creatinine ratio and self-reported retinal laser therapy, both markers for microvascular outcomes. Increases in plasma creatinine, through an as-yet unexplained mechanism, seem to be a class effect of the fibrates. While FIELD did show some significantly reduced progression of albuminuria for fenofibrate versus placebo, approximately three-fourths of patients in both groups had no change.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EThe current FIELD substudy, with evaluable results for 170 patients, investigated the effect of fenofibrate treatment on prespecified renal function parameters at baseline and at 2 and 5 years. Dr. Hiukka reported that in both groups after 5 years blood pressure dropped significantly and HbA1c remained unchanged. Fasting serum glucose dropped in both groups, but significantly only in the fenofibrate group (7.9 mmol\/L baseline, 7.2 mmol\/L 5-years; p=0.010). Although HDL-C remained unchanged in both groups, significant decreases in total cholesterol (\u223c18%; p=0.001), LDL-C (\u223c20%; p=0.001), and total triglycerides (\u223c26%; p=0.001) were reported for fenofibrate treatment versus placebo.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EIn addition, plasma creatinine increased significantly with fenofibrate (p\u0026lt;0.001) versus placebo while urinary creatinine remained the same. Creatinine clearance decreased in both groups (\u0394 \u22122.0 mL\/min\/1.73m\u003Csup\u003E2\u003C\/sup\u003E placebo, \u0394 \u22128.5 mL\/min\/1.73m\u003Csup\u003E2\u003C\/sup\u003E fenofibrate; p=0.009 vs placebo). A similar pattern was observed for eGFR [estimated glomerular filtration rate]. While there were no differences in albuminuria and proteinuria rates between groups, nocturnal urinary albumin excretion rates decreased in both groups.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EThe suggestions of benefit in the overall FIELD study were not borne out in this substudy. Dr. Hiukka concluded, \u201cThe data provide no evidence for direct nephroprotection by fenofibrate. However, in clinical practice, increases in plasma creatinine with fenofibrate should be recognized and followed up.\u201d She noted that the clinical relevance of increased plasma creatinine with fenofibrate administration should be established through direct measures of renal function. \u201cWe can\u0027t speculate on the potential harm from this finding.\u201d\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2007 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/7\/6\/11.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm7x2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}