Author: Leo
Keywords: proton pump inhibitor | PPIs | CKD
 |
| From google images |
Proton pump inhibitors (PPIs) are associated with an increased risk of chronic kidney disease (CKD), published online January 11, 2016 in JAMA Internal Medicine. The authors suggest that this widely used drug may be the cause of CKD morbidity, from the known CKD risk factors such as diabetes and high blood pressure, CKD prevalence rate faster than expected!
Proton pump inhibitors (PPIs) are associated with an increased risk of chronic kidney disease (CKD), published online January 11, 2016 in JAMA Internal Medicine. The authors suggest that this widely used drug may be the cause of CKD morbidity, from the known CKD risk factors such as diabetes and high blood pressure, CKD prevalence rate faster than expected!
In the study of community atherosclerotic risk (ARIC), the researchers compared the incidence of CKD in patients taking PPIs and without PPIs in 10,482 subjects. The median follow-up was 13.9 years. At the baseline level, 322 (3.1%) subjects in ARIC participants took PPIs.
The researchers repeated the trial method using data from 248,751 subjects in the Geisinger Health System in Pennsylvania, with a median follow-up of 6.2 years. At the baseline level, 16,900 (6.8%) cases of Geisinger patients taking outpatient prescription PPIs.
In both of these studies, the investigators excluded the following participants: Baseline assessment of glomerular filtration rate per 1.73 m 2 less than 60 mL / min or absence of data to assess glomerular filtration rate data. In these two studies, PI users were mostly white, obese and taking antihypertensive drugs. The risk is adjusted by population, socioeconomic and clinical variables, and the risk is analyzed as follows: PPI has been modeled as a time variable.
In the United States, the first PPI omeprazole was introduced in 1988. The authors point out that the use of PPI has increased significantly in both groups. For example, in the ARIC cohort, baseline data were collected from 1996 to 1999, the last follow-up in 2011, and the use of PPI climbed from 3.1% to over 25%.
During the follow-up period, 56 baseline PPI users developed CKD (14.2 / 1000 people per year) and 1,382 baseline non-users (10.7 per 1,000 persons per year.) Population, socioeconomic status, clinical measurements, common comorbidities (HR) was 1.50 (95% confidence interval [CI], 1.14-1.96) (P = 003) for baseline PPI users compared with baseline non-users compared with other drugs.
Taking into account the increase in PPI use time, the researchers established PPI as a time-varying variable used. This also indicated a significant increase in CKD risk when using PPI compared with PPI (HR, 1.35; 95% CI, 1.17-1.55; P <0.001).
Similarly, in the Geisinger Health System Cohort, 1,921CKD cases / 16,900 baseline PPI users (20.1 per 1,000 person per year). After adjustment for potential confounding factors, CDK HR was 1.17 (95% CI, 1.12-1.23; P <0.001). In the time-varying model, adjusted HR was 1.22 (P <0.001).
Baseline PPI users CKD 10 years absolute risk of 15.6%, not taking 13.9%.
Because CKD often occurs before recurrent acute kidney injury (AKI), the researchers also analyzed the association between the PPI and AKI of the two cohorts. The potential risk of AKI in ARIC subjects using PPIs at baseline levels was 1.64 times (95% CI, 1.22 to 2.21; P <0.001) for non-baseline users after adjustment for potential confounders In the repeated cohort, the adjusted risk was 1.31 (95% CI, 1.22-1.42; P <0.001). There was also a significant dose effect in the repeated cohort: AKI adjusted HR, PPI was 1.62 (95% CI, 1.32-1.98; P <0.001) twice a day 1.28 (95% CI, 1.18 ~ 1.39; P <0.001).
Email:kdtinchina@yahoo.com
whatsapp:008615931093124
