Fibrate‐induced increase in blood urea and creatinine
Bibliographic record
Abstract
Sir, Broeders et al. [1] describe 27 patients who develop renal dysfunction when treated with a fibric acid derivative. The specific agents used were fenofibrate, bezafibrate, and ciprofibrate. None of the patients were treated with gemfibrozil. Additionally, they reviewed eight articles, none of which showed an increase in creatinine with gemfibrozil treatment. We have observed a similar finding of a deterioration in renal function in 10 patients treated with fibric acid derivatives for hyperlipidaemia [2]. Some of these patients were rechallenged with another or the same fibric acid derivative for a total of 17 treatment courses. In contrast to the findings of Broeders et al., three out of a total of 17 treatment courses which resulted in deterioration in renal function involved the use of gemfibrozil. Although this is a small number of observations, we suggest that gemfibrozil may not be exempt from the potential negative effects on renal function observed with other fibric acid derivatives and that, as with other agents in this class, vigilance and monitoring is warranted with its use in patients with pre‐existing renal impairment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.011 | 0.008 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".