3D DIR is increasingly used in neuroradiology. Compared with STIR FLAIR, 3D DIR improves detection of optic neuritis. Multiplanar analysis had the best diagnostic performance for optic nerve signal abnormalities. Sensitivity was 95% and specificity 94%. Findings support the use of 3D DIR instead of 2D sequences.
Aims
Long‐term use of proton pump inhibitors (PPIs) has been associated with adverse kidney events in the general population, but their impact among chronic kidney disease (CKD) patients is unclear. We studied the prevalence and incidence (new users) of PPI prescriptions and their relation to kidney outcomes and mortality in CKD patients.
Methods
We collected drug prescriptions prospectively in a cohort of 3023 nephrology outpatients with CKD stages 2–5 at inclusion. Hazard ratios (HR, 95% confidence intervals [95% CI]) for acute kidney injury (AKI), end‐stage kidney disease (ESKD), and mortality associated with new PPI prescriptions as a time‐dependent variable were estimated with cause‐specific Cox models in 1940 non‐users with eGFR ≥ 15 mL/min/1.73 m2 at baseline, adjusted for comorbidities, laboratory data and drugs.
Results
There were 981/3023 (32%) prevalent users (67 ± 13 years, 65% men) at baseline, and 366/3023 (12%) were prescribed PPI (new users) over a median follow‐up of 3.9 years (interquartile range, 3–4.2). Among these new users, their median cumulative duration of prescription was 1 year (interquartile range: 0.4–2.3). During follow‐up, 354 patients developed ESKD and 216 died before ESKD. The adjusted HRs associated with PPI prescription were 1.74 (95% CI, 1.26–2.40) for ESKD and 2.42 (95% CI, 1.73–3.39) for all‐cause mortality. Over the first 3 years of follow‐up, 211 AKI events had occurred. The adjusted HR for AKI associated with PPI prescription was 2.89 (95% CI, 1.91–4.38).
Conclusions
Long‐term PPI prescription was common in CKD patients. Our results call attention to its potential risks of both acute and chronic kidney failure.
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