Goldberg A P, Sherrard D J, Haas L B, Brunzell J D
Clin Pharmacol Ther. 1977 Mar;21(3):317-25. doi: 10.1002/cpt1977213317.
A daily dose of 1.5 to 2.0 gm of clofibrate lowers serum triglyceride (TG) levels in patients with normal renal function but causes muscle toxicity and elevated creatine phosphokinase (CPK) levels in patients with long-term renal failure. Plasma clofibrate disappearance is prolonged as much as seven times normal in severely uremic patients. A marked reduction in the standard 14 gm/wk clofibrate dose to a total dose of 1.0 to 1.5 gm/wk effectively lowered serum TG levels (--28%, p less than 0.02) in hypertriglyceridemic hemodialysis patients without toxicity. The serum clofibrate level at this dose was comparable to that in hypertriglyceridemic nonuremic patients receiving 14 gm/wk of clofibrate. The dose of clofibrate administered to hemodialysis patients can be adjusted to avoid toxicity and provide the desired therapeutic effect by monitoring serum CPK and TG levels.
每日服用1.5至2.0克氯贝丁酯可降低肾功能正常患者的血清甘油三酯（TG）水平，但会导致长期肾衰竭患者出现肌肉毒性并使肌酸磷酸激酶（CPK）水平升高。在严重尿毒症患者中，血浆氯贝丁酯的清除时间延长至正常的七倍之多。将标准的每周14克氯贝丁酯剂量显著减少至每周1.0至1.5克的总剂量，可有效降低高甘油三酯血症血液透析患者的血清TG水平（降低28%，p<0.02），且无毒性。此剂量下的血清氯贝丁酯水平与接受每周14克氯贝丁酯的高甘油三酯血症非尿毒症患者相当。通过监测血清CPK和TG水平，可调整给予血液透析患者的氯贝丁酯剂量，以避免毒性并提供所需的治疗效果。
