Author: Leo
Keywords: PPIs | kidney damage
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There is growing evidence that the use of proton pump inhibitors (PPIs) increases the risk of chronic kidney disease, disease progression, and end-stage renal disease (ESRD). Analysis of the national consolidated database shows that the longer the use of the time, the greater the risk.
There is growing evidence that the use of proton pump inhibitors (PPIs) increases the risk of chronic kidney disease, disease progression, and end-stage renal disease (ESRD). Analysis of the national consolidated database shows that the longer the use of the time, the greater the risk.
"The findings highlight the importance of limiting the use of PPI, which is only necessary for the necessary medical needs and limiting its use of time to the shortest possible time," said Dr. Ziyad Al-Aly, MD, of the main author, Missouri St. Louis Veterans Administration Medical System, "Many patients are taking PPIs for physical condition, and they take more time than needed," the press conference said.
The first author Yan Xie is also from the Missouri St. Louis Veterans Administration Medical System, which was published online April 14, 2016 at the American Society of Nephrology.
National Veterans Administration Database
The researchers used the National Veterans Administration's database to identify 173,321 users of PPI, as well as 20,270 patients with histamine 2 receptor antagonists (H2 receptor blockers). As the study authors point out, both drugs can be used for the same evidence.
During the 5-year follow-up, patients with PPI were more likely to be younger than the estimated glomerular filtration rate (eGFR) of 60 mL / minute per 1.73 m2 (hazard ratio [HR], 1.22 ; 95% confidence interval [CI], 1.18 ~ 1.26).
In addition, the possibility of CKD was more than 28% in the PPI group than the H2 receptor antagonist group (CK, 1.28; 95% CI, 1.23 to 1.34).
In the PPI group, 53% had a doubling of serum creatinine in the H2 receptor antagonist group (32.7% of the PPI group affected by the PPI group and 3.74% in the H2 group); 32% may be more prone to eGFR than 30% (19.48 % Vs 25.30%), 96% of the likelihood of developing to end-stage renal disease (0.12% vs 0.19%).
Long time is equivalent to high risk
"In addition, 1 to 90, 91 to 180, 181 to 360 and 361 to 720 days of the use of PPI population, compared with taking ≤ 30 days of the crowd, we found that PPI use time and renal prognosis risk level.
The researchers cautioned that although the association between PPI use and adverse kidney endpoints was significant, but CKD events, serum creatinine doubled, more than 30% of eGFR decreased, in the analysis of relatively little. Therefore, the results should not prevent PPI prescription applications.
CKD risk significantly
A JAMA Internal Medicine early observation study also found that PPI-associated CKD risk increased by 35% (P <0.001) compared with the absence of PPI population. Mark Perazella, a professor of medicine at Yale University School of Medicine, is an expert in the study of the effects of drugs on the kidneys. He is familiar with both studies and has seen it in a summary and poster of the American Kidney Week in the California American Kidney Association last year. It was not surprising to the results of the two studies.
However, as Dr. Perazella warned, no studies have shown that PPIs actually cause poor kidney function results. "It must be remembered that these are epidemiological studies that do not prove causality," he stressed. Indeed, the authors of JAMA Internal Medicine have pointed out that their research does not provide evidence of causality.
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