Results:

Mean age in both groups was 73 years. The fibrate group had 2% more with diabetes, 13% less coronary disease, similar renal function, and was less likely to be on angiotensin-converting enzyme inhibitor or angiotensin-receptor blockers. Compared with ezetimibe users (n = 61,831), fibrate users (n = 19,072) were more likely to be hospitalized for an increase in serum creatinine level (adjusted odds ratio, 2.4; 95% confidence interval [CI], 1.7-3.3) and were more likely to consult a nephrologist (absolute risk difference, 0.15%; 95% CI, 0.01-0.29; adjusted odds ratio, 1.3; 95% CI, 1.0-1.6). There were no differences between groups in the risk for all-cause mortality or receiving dialysis for severe acute kidney injury. In a subpopulation of 1,110 patients (fibrates, n = 220; ezetimibe, n = 890), 9.1% of fibrate users and 0.3% of ezetimibe users had an increase in serum creatinine level of 50% or more (absolute difference, 8.8%; 95% CI, 4.5-13.1; odds ratio, 29.6; 95% CI, 8.7-100.5). Risks were greater among fibrate users with chronic kidney disease.