Three months of bempedoic acid treatment does not affect cystatin C-based estimation of glomerular filtration rate.

High Blood Press Cardiovasc Prev

Unit of Internal Medicine and Nephrology, Department of Life, Environmental Science and Health, Center for Hypertension and Cardiovascular Prevention, School of Internal Medicine, University of L'Aquila, San Salvatore Hospital, Rita Levi Montalcini Building Delta 6, 67100, Coppito, L'Aquila, AQ, Ita

Published: August 2025


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Article Abstract

Introduction: Bempedoic acid can interfere with creatinine excretion, thereby potentially altering the calculation of glomerular filtration rate (eGFR), but is not known to have an effect on cystatin C metabolism.

Aim: The aim of this pilot observational study was to assess the impact of 3-months bempedoic acid treatment on renal function assessed by serum creatinine and cystatin C.

Methods: Consecutive hypercholesterolemic outpatients with indication to be started on bempedoic acid and available serum creatinine and cystatin C levels were enrolled. Follow-up (45-90 days) renal function markers were assessed. Lipid profile, uric acid levels, and CRP levels were also recorded.

Results: Bempedoic acid reduced LDL-c and total cholesterol levels by day 45. No changes were observed in HDL-c, triglycerides, Lp(a), serum creatinine, eGFR, BUN, uric acid, or CRP levels throughout the study. The sensitivity analysis on individuals with complete data for cystatin C during follow-up (42%) confirmed the overall observations, while also showing neutral effects of bempedoic acid eGFR and eGFR.

Conclusions: Three-months administration of bempedoic acid did not affect cystatin C levels. Adequately powered studies are needed to test these findings and, ultimately, the renal safety of bempedoic acid.

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http://dx.doi.org/10.1007/s40292-025-00732-xDOI Listing

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