Yuzuncu Yil University, Medical Faculty, Department of Internal Medicine, Van, Turkey.
Clin Biochem. 2012 Jan;45(1-2):162-4. doi: 10.1016/j.clinbiochem.2011.09.025. Epub 2011 Oct 14.
Fenofibrate is a fibric acid derivative that is used alone or combination with statins in the treatment of hyperlipidemia. These drugs have potential risks, including rhabdomyolysis and acute renal failure. Despite reports of rhabdomyolysis with the use of fenofibrate alone or with statin-fibrate combinations, there have been no cases of rhabdomyolysis described when fenofibrate was used alone to treat patients with chronic renal failure owing to nephrotic syndrome.
We report on a 26-year-old male who presented with fenofibrate-induced rhabdomyolysis with chronic renal failure due to nephrotic syndrome.
After the discontinuation of fenofibrate, the patient was treated with intravenous fluid replacement and urine alkalization. Subsequently, his clinical and biochemical findings improved.
Before starting fenofibrate therapy, the causes of secondary hyperlipidemia, especially nephrotic syndrome, should be investigated. In the presence of chronic renal failure and hypoalbuminemia, the fenofibrate dose should be adjusted. Physicians should be aware of the potential toxicities of fenofibrate, and patients should be informed about its potential side effects.
非诺贝特是一种纤维酸衍生物，可单独或与他汀类药物联合用于治疗高脂血症。这些药物存在潜在风险，包括横纹肌溶解和急性肾衰竭。尽管有报道称单独使用非诺贝特或与他汀类药物联合使用非诺贝特会导致横纹肌溶解，但尚未有报道称在因肾病综合征导致慢性肾衰竭的患者中单独使用非诺贝特治疗时会发生横纹肌溶解。
我们报告了一名 26 岁男性患者，因肾病综合征导致慢性肾衰竭，出现非诺贝特诱导的横纹肌溶解症。
停用非诺贝特后，患者接受了静脉补液和尿液碱化治疗。随后，他的临床和生化指标得到改善。
在开始非诺贝特治疗之前，应调查继发性高脂血症的原因，特别是肾病综合征。在存在慢性肾衰竭和低白蛋白血症的情况下，应调整非诺贝特的剂量。医生应了解非诺贝特的潜在毒性，应告知患者其潜在的副作用。
