Stable Cystatin C Serum Levels Confirm Normal Renal Function in Patients With Dronedarone-Associated Increase in Serum Creatinine

Jul 31, 2012
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Authors:
Duncker D, Oswald H, Gardiwal A, et al.
Citation:
J Cardiovasc Pharmacol Ther 2012;Jul 26:[Epub ahead of print].
Summary By:
Fred Morady, MD, FACC

Study Questions:

Does dronedarone impair renal function?

Methods:

The subjects of this study were 20 patients (mean age 54 years) with atrial fibrillation treated with dronedarone, 400 mg twice daily. Serum levels of creatinine and cystatin C were measured before treatment and at 10 and 90 days of treatment with dronedarone.

Results:

The serum creatinine level increased significantly in 5/20 patients, rising from a baseline of 82.4 µmol/L to 104 µmol/L at 10 days of treatment. In the other 15 patients, the serum creatinine level did not change significantly during treatment with dronedarone. The baseline serum cystatin C levels were similar in the two groups of patients and did not change significantly during treatment with dronedarone in either group.

Conclusions:

The increase in serum creatinine concentration that may occur during treatment with dronedarone is not caused by a reduction in renal function.

Perspective:

Cystatin C is eliminated only by glomerular filtration and, therefore, is an accurate indicator of glomerular filtration rate. The fact that cystatin C levels were not affected by dronedarone indicates that the rise in serum creatinine that occurred in some patients treated with dronedarone was not caused by a decrease in glomerular filtration rate. Other studies have shown that the rise in serum creatinine probably is caused by inhibition of the cation transporter involved in tubular secretion of creatinine.

Keywords: Biomarkers, Glomerular Filtration Rate, Creatinine, Cystatin C


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