Use of gastric-acid suppressants may be a risk factor for enteric peritonitis in patients undergoing peritoneal dialysis: A meta-analysis

Zhong, Hao‐Jie; Lin, Dongdong; Lu, Zhi‐Yong; Yang, Wu; Chen, Yu

doi:10.1111/jcpt.12769

Cited by 16 publications

(22 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, in PD patients, few studies have reported the association between PPIs and PD-related peritonitis [15,22–24], and no previous studies have shown the significant association between PPIs and PD-related peritonitis. Thus far, only one recent meta-analysis consisting of 6 observational studies involving 378 PD patients has evaluated the relationship between PPI, H2RA, and enteric peritonitis [15]. Although the results showed that H2RA use in PD patients was associated with an increased risk of enteric peritonitis (odds ratio [OR] = 1.27; 95% CI: 1.02‐1.57), PPI use was not identified as a risk factor (OR = 1.13; 95% CI: 0.72‐1.77); the results should be interpreted cautiously in the following points.…”

Section: Discussionmentioning

confidence: 99%

“…However, the dose of ranitidine examined in the study [26] was higher than the current recommended dose for PD patients; therefore, the result could not be applied. In a different point of view, most of the previous studies in PD patients had evaluated the association between PPI or H2RA and “enteric” peritonitis, which was caused by the enteric organisms [15,22,23,26]. However, the definition of “enteric” organisms was different in each study, namely, enteric bacteria included in each study was different.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding PD patients, the relationship between PPIs and peritonitis has not been extensively studied. Zhong et al reported a meta-analysis showing a significant association between H2-receptor antagonist (H2RA) use and “enteric peritonitis”; peritonitis was caused by enteric bacteria, but PPI use was not identified as a risk factor [15]. However, the study sample size was small, which might have led to the underestimation of the influence of PPIs.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients

Maeda¹,

Yamaguchi

Maeda³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

Peritonitis is a major and the most significant complication of peritoneal dialysis (PD). Although some predictors of peritonitis in PD patients are known, the association between proton pump inhibitor (PPI) use and peritonitis has not been characterized. Here, we examined whether PPI use is a risk factor for the development of peritonitis, based on a single-center retrospective analysis of 230 consecutive Japanese PD patients at Narita Memorial Hospital. We assessed the association between PPI use and subsequent first episode of peritonitis using multivariate Cox proportional hazards models, following adjustment for clinically relevant factors. The median follow-up period was 36 months (interquartile range, 19–57 months). In total, 86 patients (37.4%) developed peritonitis. Analysis with multivariate Cox proportional hazards models revealed the following significant predictors of peritonitis: PPI use (adjusted hazard ratio [HR] = 1.72, 95% confidence interval [CI]: 1.11–2.66; P = 0.016) and low serum albumin level (per g/dl adjusted HR = 0.59, 95% CI: 0.39–0.90; P = 0.014). Thus, PPI use was independently associated with PD-related peritonitis. The results suggest that nephrology physicians should exercise caution when prescribing PPIs for PD patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients

Maeda¹,

Yamaguchi

Maeda³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…However, emerging studies have suggested that long-term use of PPIs may be associated with several adverse effects, such as bacterial pneumonia, osteoporotic-related fractures, kidney disease, impaired absorption of nutrients, ischemic stroke, cardiovascular events, and even, the risk of cancer [1,[4][5][6][7][8][9][10][11][12]. Long-term acid suppression facilitates the development of fundic ECL cell hyperplasia, overgrowth of non-Helicobacter pylori bacterial species, lower the acid bactericidal effects for harmful microorganisms and alters the natural course of Helicobacter pylori gastritis, transforming the antral-predominant pattern into a body-predominant pattern [13].…”

Section: Introductionmentioning

confidence: 99%

Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study

Kuo

Lin

Chen

et al. 2021

JPM

View full text Add to dashboard Cite

Long-term use of gastric-acid-suppressive drugs is known to be associated with several adverse effects. However, the association between enteric infection and acid suppression therapy is still uncertain. This study aimed to evaluate the association between gastric acid suppression and the risk of enteric infection. Materials and Methods: We conducted a population-based case-control study using the data from Chang Gung Research Database (CGRD) in Taiwan. Between January 2008 and December 2017, a total of 154,590 adult inpatients (age > 18) were identified. A pool of potential eligible controls according to four propensity scores matching by sex, age, and index year were extracted (n = 89,925). Subjects with missing data or who received less than 7 days of proton pump inhibitors (PPIs) and/or H2-receptor antagonists (H2RAs) were excluded. Finally, 17,186 cases and 69,708 corresponding controls were selected for analysis. The use of PPIs and H2RAs, the result of microbiological samples, and co-morbidity conditions have been analyzed. Confounders were controlled by conditional logistic regression. Results: 32.84% of patients in the case group used PPIs, compared with 7.48% in the control group. Of patients in the case group, 9.9% used H2RAs, compared with 6.9% in the control group. Of patients in the case group, 8.3% used a combination of PPIs and H2RAs, compared with 2.7% in the control group. The most common etiological pathogens were Enterococcus (44.8%), Clostridioides difficile (34.5%), and Salmonella spp. (10.2%). The adjusted odds ratio (OR) for PPI use with enteric infection was 5.526 (95% confidence interval [CI], 5.274–5.791). For H2RAs, the adjusted odds ratio was 1.339 (95% confidence interval [CI], 1.261–1.424). Compared to the control group, persons with enteric infection had more frequent acid-suppressive agent usage. Conclusions: This study demonstrates that gastric-acid-suppressive drug use is associated with an increased risk of enteric infection after adjusting for potential biases and confounders.

show abstract

Effectiveness and Safety of Histamine H2 Receptor Antagonists: An Umbrella Review of Meta‐Analyses

Meng

Chen

Zhang

et al. 2022

The Journal of Clinical Pharma

View full text Add to dashboard Cite

Histamine H2 receptor antagonists (H2RAs) were widely used to inhibit gastric acid secretion, but its association with adverse events remains controversial and unclear. We conducted an umbrella review of meta-analyses to systematically assess the quality and credibility of the correlations between H2RA use with the risk of adverse outcomes through searching 4 major databases from inception to April 30, 2022. Forty-six individual metaanalyses were identified, including 29 meta-analyses of observation studies with 32 unique outcomes and 19 meta-analyses of randomized controlled trials with 3 unique outcomes for comparing the H2RA versus non-H2RA group. A Measurement Tool to Assess Systematic Reviews 2 rating for the included meta-analyses showed that 4 of 46 meta-analyses were assigned as high scores, 3 were assigned as "moderate," and 25 were assigned as low scores. Grading of Recommendations Assessment, Development and Evaluation assessment for combined results demonstrated that 6 outcomes were rated as "moderate," 9 outcomes were rated as "low," and 17 outcomes were rated as "very low." We confirmed significant associations of H2RA use with pneumonia, peritonitis, necrotizing enterocolitis, Clostridium difficile infection, liver cancer, gastric cancer, and hip fracture diseases. No associations for colorectal cancer, melanoma, kidney cancer, lung cancer, or common reproductive system cancer or renal, neurological, and cardiovascular system diseases were observed. We found a variety of evidence for the associations between H2RAs and adverse outcomes, which would give clinicians more positive guidance on prescription of H2RAs in clinical practice.

show abstract

Use of gastric-acid suppressants may be a risk factor for enteric peritonitis in patients undergoing peritoneal dialysis: A meta-analysis

Cited by 16 publications

References 51 publications

Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients

Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients

Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study

Effectiveness and Safety of Histamine H2 Receptor Antagonists: An Umbrella Review of Meta‐Analyses

Contact Info

Product

Resources

About