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Original Article
- Complications
- Switching from Conventional Fibrates to Pemafibrate Has Beneficial Effects on the Renal Function of Diabetic Subjects with Chronic Kidney Disease
- Rimi Izumihara, Hiroshi Nomoto, Kenichi Kito, Yuki Yamauchi, Kazuno Omori, Yui Shibayama, Shingo Yanagiya, Aika Miya, Hiraku Kameda, Kyu Yong Cho, So Nagai, Ichiro Sakuma, Akinobu Nakamura, Tatsuya Atsumi, on Behalf of the PARM-TD Study Group
- Diabetes Metab J. 2024;48(3):473-481. Published online February 29, 2024
- DOI: https://doi.org/10.4093/dmj.2023.0370
- 8,755 View
- 488 Download
- 9 Web of Science
- 10 Crossref
-
Abstract
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Supplementary Material
PubReader 
ePub - Background
Fibrates have renal toxicity limiting their use in subjects with chronic kidney disease (CKD). However, pemafibrate has fewer toxic effects on renal function. In the present analysis, we evaluated the effects of pemafibrate on the renal function of diabetic subjects with or without CKD in a real-world clinical setting.
Methods
We performed a sub-analysis of data collected during a multi-center, prospective, observational study of the effects of pemafibrate on lipid metabolism in subjects with type 2 diabetes mellitus complicated by hypertriglyceridemia (the PARM-T2D study). The participants were allocated to add pemafibrate to their existing regimen (ADD-ON), switch from their existing fibrate to pemafibrate (SWITCH), or continue conventional therapy (CTRL). The changes in estimated glomerular filtration rate (eGFR) over 52 weeks were compared among these groups as well as among subgroups created according to CKD status.
Results
Data for 520 participants (ADD-ON, n=166; SWITCH, n=96; CTRL, n=258) were analyzed. Of them, 56.7% had CKD. The eGFR increased only in the SWITCH group, and this trend was also present in the CKD subgroup (P<0.001). On the other hand, eGFR was not affected by switching in participants with severe renal dysfunction (G3b or G4) and/or macroalbuminuria. Multivariate analysis showed that being older and a switch from fenofibrate were associated with elevation in eGFR (both P<0.05).
Conclusion
A switch to pemafibrate may be associated with an elevation in eGFR, but to a lesser extent in patients with poor renal function. -
Citations
Citations to this article as recorded by
- Beyond lipids: fenofibrate in diabetic retinopathy and nephropathy
Mengying Liu, Seok Ting Lim, Weihua Song, Thomas M. Coffman, Xiaomeng Wang
Trends in Pharmacological Sciences.2026; 47(3): 325. CrossRef - Hypertriglyceridemia in chronic kidney disease: pathophysiological mechanisms, cardiovascular risk, and emerging therapeutics
Dandan Li, Zhanju Liu, Hongwei Jiang
Lipids in Health and Disease.2026;[Epub] CrossRef - Peroxisome proliferator-activated receptors in kidney diseases: A promising therapeutic target
Qiuyi Li, Zhenwei Shi, Xiujie Shi, Hang Xing, Yu Zhang, Shougang Zhuang, Meiying Chang
Biomedicine & Pharmacotherapy.2026; 195: 118983. CrossRef - Current perspectives on lipid management in diabetic kidney disease: Can fibrates offer advantages over statins for renal outcomes?
Mohammad Reza Chitsazi, Farzad Safari, Elena Malekpour, Seyed Arsham Mirzaei, Mohammad Hossein Shafieyoun, Faraz Golafshan, Hanieh Rouzbahani, Mohadese Nekookhoo, Ali Noursina, Mansour Siavash
Journal of Research in Medical Sciences.2026;[Epub] CrossRef - Molecular Mechanisms and Clinical Evidence Supporting the Four Pillars of Therapy in Diabetic Kidney Disease: Emerging Therapeutic Perspectives
Hidekatsu Yanai, Hiroki Adachi, Mariko Hakoshima, Hisayuki Katsuyama
International Journal of Molecular Sciences.2026; 27(6): 2757. CrossRef - Switching from Conventional Fibrates to Pemafibrate Improves Lipid Profiles, Liver Enzymes, Renal Function, and Fibrosis Markers in Dyslipidemic Patients with MASLD: A Multicenter Real-World Study
Takao Sato, Toshihiro Miyamoto, Ryoma Fukuoka, Kazumasa Sugimoto, Yoko Tanimoto, Takashi Nakayama, Kojiro Tanimoto, Koichiro Sugimura, Yoshihide Fujimoto, Takahiko Kiyooka, Akio Kawamura
Journal of Atherosclerosis and Thrombosis.2026;[Epub] CrossRef - Managing Dyslipidemia in Chronic Kidney Disease: Implications for Cardiovascular and Renal Risk
Panagiotis Theofilis, Panayotis K. Vlachakis, Paschalis Karakasis, Rigas G. Kalaitzidis
Current Atherosclerosis Reports.2025;[Epub] CrossRef - Fibrates : Do They Still Have a Role in Therapy in 2025?
Angela Pirillo, Alberto Zambon, Alberico L. Catapano
Current Atherosclerosis Reports.2025;[Epub] CrossRef - Research hotspots and future trends in lipid metabolism in chronic kidney disease: a bibliometric and visualization analysis from 2004 to 2023
Ying Wang, Tongtong Liu, Weijing Liu, Hailing Zhao, Ping Li
Frontiers in Pharmacology.2024;[Epub] CrossRef - Impact of Conversion from Conventional Pemafibrate to Novel Pemafibrate XR on Hypertriglyceridemia: An Observational Retrospective Study
Yuki Hida, Teruhiko Imamura, Koichiro Kinugawa
Journal of Clinical Medicine.2024; 13(19): 5879. CrossRef
- Beyond lipids: fenofibrate in diabetic retinopathy and nephropathy
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