PPI Use Tied to Risk of CKD Progression
The use of proton pump inhibitors (PPIs) is associated with increased risk of chronic kidney disease (CKD) progression, according to a recent study.
Existing evidence has indicated that PPI use is associated with acute kidney injury (AKI). However, less is known about the potential association between PPI use and the risk of CKD.
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For their study, the researchers assessed new users of PPIs (n=105,305) and new users of H2 blockers (H2B) (n=9578). Patient data were obtained via the Stockholm creatinine measurements database. Data on renal outcomes were recorded for a median of 2.7 years.
The primary outcome was the progression of CKD, defined as the doubling of creatinine or the decrease in estimated glomerular filtration rate of 30% or more. Secondary outcomes were defined as end-stage renal disease and AKI. The time-dependent risk associated with cumulative exposure to PPIs was modeled using the complete collection of repeated PPI and H2B dispensations at pharmacies in Sweden.
Results indicated that PPI use was associated with a higher risk of doubled creatinine levels (1985 events) and a decrease in estimated glomerular filtration rate of 30% or more (11,045 events), compared with H2B use. The researchers had also observed associations of PPI use with the development of end-stage renal disease and AKI.
Ultimately, the researchers found that there was a graded association between cumulative PPI exposure and the risk of CKD progression. However, H2B use was not found to be associated with the risk of CKD progression.
“Initiation of PPI therapy and cumulative PPI exposure is associate with increased risk of CKD progression in a large, North European healthcare system,” the researchers concluded. “Although consistent, the association was modest in magnitude, and cannot exclude residual confounding.”
—Christina Vogt
Reference:
Klatte DCF, Gasparini A, Xu H, et al. Association between proton pump inhibitor use and risk of progression of chronic kidney disease. Gastroenterology. 2017;153(3):702-710. http://dx.doi.org/10.1053/j.gastro.2017.05.046.