Proton pump inhibitors use and risk of chronic kidney disease and end-stage renal disease

Vengrus, Carolina S; Delfino, Vinícius Daher Alvares; Bignardi, P

doi:10.23736/s2724-6051.21.04116-3

Cited by 12 publications

(9 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 140 Although a comprehensive review of general PPI adverse events is beyond the scope of this article, it is important to note that the Food and Drug Administration (FDA) has specifically cautioned PPI standard dose users on the risks for Clostridioides (formerly clostridium) difficile infection, 141 bone fractures 142 and hypomagnesemia. 143 There have been numerous meta-analyses for standard dose PPI therapy citing both associations and lack of association of PPI use and pneumonia, 144–148 other enteric infections, 149–151 gastric atrophy and cancer, 152–154 chronic kidney disease, 155–159 diabetes, 160 , 161 chronic obstructive lung disease, 162 , 163 dementia, 164–169 cardiovascular disease or cardiovascular events, 170–175 and all-cause mortality. 176–180 However, it is likely that most of the reported potential risks are due to residual confounding within the study design, 180–183 and a large-scale, industry sponsored randomized controlled trial recently emphasized the safety of this medication class and refuted most of the prior proposed associations.…”

Section: Ppi Adverse Events In Adults With Eoementioning

confidence: 99%

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Franciosi¹,

Mougey²,

Dellon³

et al. 2022

JAA

View full text Add to dashboard Cite

Over the past decade, the role of proton pump inhibitor (PPI) medication has evolved from a diagnostic tool for Eosinophilic Esophagitis (EoE), by excluding patients with PPI responsive esophageal eosinophilia (PPI-REE), to a therapy for EoE. This transition resulted from the Updated International Consensus Diagnostic Criteria for Eosinophilic Esophagitis: Proceedings of the Appraisal of Guidelines for Research and Evaluation II (AGREE) Conference to support PPI therapy for EoE in children and adults. Additional recent advances have suggested a role for genetic variations that might impact response to PPI therapy for EoE. This review article will explore a brief background of EoE, the evolution of PPI therapy for EoE and its proposed mechanisms, efficacy and safety in children and adults, and considerations for future PPI precision medicine in patients with EoE.

show abstract

Section: Ppi Adverse Events In Adults With Eoementioning

confidence: 99%

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Franciosi¹,

Mougey²,

Dellon³

et al. 2022

JAA

View full text Add to dashboard Cite

show abstract

“…A history of PPI and NSAID use, hypertension, and chronic liver disease has been identified as risk factors for the development of renal impairment [16, 37, 38]. In addition, PPIs have a risk ratio of 1.4 to 1.6 for developing CKD [39, 40]. Other drugs that may accelerate CKD progression include Mg, DOAC, and CDDP, and in this study, five drugs (PPI, NSAID, Mg, DOAC, and CDDP) were defined as drugs with a high risk of renal dysfunction, and their association with renal failure was investigated [41, 42].…”

Section: Discussionmentioning

confidence: 99%

Impact of Renal Function on the Prognosis of Patients Receiving Atezolizumab/Bevacizumab Combination Therapy and Lenvatinib Monotherapy for Unresectable Hepatocellular Carcinoma

Takada¹,

Yamashita²,

Osawa³

et al. 2023

Oncology

View full text Add to dashboard Cite

Introduction: Several studies have reported kidney injury caused by immune checkpoint inhibitors, and proteinuria caused by vascular endothelial growth factor inhibitors for unresectable hepatocellular carcinoma (u-HCC). We investigated the relationship between renal function and prognosis in patients with u-HCC receiving atezolizumab and bevacizumab (AB) and lenvatinib (LEN) therapy. Methods: Fifty-one patients who received AB and 50 patients who received LEN therapy were included. We analyzed prognostic factors related to the overall survival (OS), and characteristics related to renal function. Results: In patients with AB therapy, OS was shorter in patients with baseline proteinuria of 1+ or higher, as assessed by urine dipstick test, compared to those with –/± (p = 0.024). There were many cases with two or more drugs with a high risk of renal dysfunction (p = 0.019) in patients with 1+ or higher. Furthermore, OS was shorter in the group with estimated glomerular filtration rate (eGFR) grade deterioration without urinary protein-creatinine ratio (UPCR) of 2 g/g·Cre or higher than in the other groups (p = 0.027). In the group where eGFR worsened without an increase in UPCR, there were many cases with a daily salt intake of 10 g or more (p = 0.027), three or more drugs with a high risk of renal dysfunction (p = 0.021), and a history of arteriosclerosis (p = 0.021). On the other hand, in patients with LEN therapy, OS tends to be shorter in patients with proteinuria of ± or higher, compared to those without (p = 0.074). There were many cases with a daily salt intake of 10 g or more in patients with ± or higher (p = 0.002). Conclusion: In patients receiving AB and LEN therapy, baseline proteinuria was associated with OS. Renal function deterioration without proteinuria was associated with a poor prognosis in AB therapy. Excessive salt intake, preexisting atherosclerotic disease, and drug with a high risk of renal dysfunction were risk factors for renal deterioration.

show abstract

“…In addition, Arora et al (2016) and Xie et al (2016) also found that PPI use was associated with a 10–28% higher risk of CKD. Some meta-analysis studies summarized the aforementioned three studies and indicated that PPI use was associated with a higher risk of CKD ( Wijarnpreecha et al, 2017 ; Qiu et al, 2018 ; Al-Aly et al, 2020 ; Vengrus et al, 2021 ). However, a lack of adjustment for several important confounders, such as diet, alcohol intake, and physical activity, might introduce bias in the findings ( Desbuissons and Mercadal, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…The growing drug use, like NSAIDs, may also contribute to the higher prevalence of CKD ( Hsu et al, 2015 ; Tuttle et al, 2019 ). There is accumulating evidence that PPI use might affect kidney function and thus result in CKD ( Xie et al, 2016 ; Al-Aly et al, 2020 ; Vengrus et al, 2021 ). For example, a meta-analysis of six cohorts and two case–control studies found that PPI use was associated with a 35% higher risk of CKD [risk ratios (RR) 1.35, 95% confidence interval (CI), 1.15–1.56] ( Vengrus et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…There is accumulating evidence that PPI use might affect kidney function and thus result in CKD ( Xie et al, 2016 ; Al-Aly et al, 2020 ; Vengrus et al, 2021 ). For example, a meta-analysis of six cohorts and two case–control studies found that PPI use was associated with a 35% higher risk of CKD [risk ratios (RR) 1.35, 95% confidence interval (CI), 1.15–1.56] ( Vengrus et al, 2021 ). These observational studies are thought-provoking but have important limitations to the evidence base, such as either inaccurate exposure measurements through retrospective recall or administrative claims data or nonavailability of potential confounders such as lifestyle factors ( Freedberg et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank

Zhang

Jing

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

Background: Proton pump inhibitors (PPIs) are widely used and have been linked to kidney diseases. However, the role of PPI use in the development of chronic kidney disease (CKD) remains unclear. We undertook this study to examine the association between PPI use and the subsequent risk of CKD.Methods: This is a prospective analysis of 462,421 participants free of cancer diagnosis or chronic kidney disease from the United Kingdom Biobank. Self-reported PPI use was recorded using an electronic questionnaire and confirmed by a trained staff. Incident CKD was identified based on the medical history. Overlap propensity score weighting with the Cox model was used to calculate the effect of PPI use on CKD risk. The number needed to harm (NNH) was calculated at 5 and 10 years of follow-up.Results: We documented 7,031 cases of CKD over a median follow-up of 8.1 years. Overlap propensity score weighting analysis showed that regular PPI users had a 37% higher risk of CKD incident than non-users (HR 1.37, 95% CI 1.28–1.47). The association persisted across subgroup analyses, different types of PPIs, and several sensitivity analyses. Quantitative bias analysis indicated that the result was robust to unmeasured confounding (E-value 2.08, lower 95% CI 1.88). The NNH was 147.9 and 78.6 for 5 and 10 years of follow-up, respectively. A head-to-head comparison showed that PPI users had a 19% higher risk of CKD than H2RA users (HR 1.19, 95% CI 1.02–1.39).Conclusion: The regular use of PPI is associated with a higher risk of CKD. Healthcare providers should carefully weigh up the potential benefits against the risk in prescribing PPIs, particularly for patients requiring long-term treatment.

show abstract

Proton pump inhibitors use and risk of chronic kidney disease and end-stage renal disease

Cited by 12 publications

References 43 publications

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Proton Pump Inhibitor Therapy for Eosinophilic Esophagitis: History, Mechanisms, Efficacy, and Future Directions

Impact of Renal Function on the Prognosis of Patients Receiving Atezolizumab/Bevacizumab Combination Therapy and Lenvatinib Monotherapy for Unresectable Hepatocellular Carcinoma

Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank

Contact Info

Product

Resources

About