Proton pump inhibitors are associated with increased risk of development of chronic kidney disease

Abstract

BackgroundAcute interstitial nephritis secondary to proton pump inhibitors (PPIs) frequently goes undiagnosed due to its subacute clinical presentation, which may later present as chronic kidney disease (CKD). We investigated the association of PPI use with the development of CKD and death.MethodsTwo separate retrospective case–control study designs were employed with a prospective logistic regression analysis of data to evaluate the association of development of CKD and death with PPI use. The population included 99,269 patients who were seen in primary care VISN2 clinics from 4/2001 until 4/2008. For evaluation of the CKD outcome, 22,807 with preexisting CKD at the first observation in Veterans Affairs Health Care Upstate New York (VISN2) network data system were excluded. Data obtained included use of PPI (Yes/No), demographics, laboratory data, pre-PPI comorbidity variables.ResultsA total of 19,311/76,462 patients developed CKD. Of those who developed CKD 24.4 % were on PPI. Patients receiving PPI were less likely to have vascular disease, COPD, cancer and diabetes. Of the total of 99,269 patients analyzed for mortality outcome, 11,758 died. A prospective logistic analysis of case–control data showed higher odds for development of CKD (OR 1.10 95 % CI 1.05–1.16) and mortality (OR 1.76, 95 % CI 1.67–1.84) among patients taking PPIs versus those not on PPIs.ConclusionsUse of proton pump inhibitors is associated with increased risk of development of CKD and death. With the large number of patients being treated with proton pump inhibitors, healthcare providers need to be better educated about the potential side effects of these medications.

Proton-pump inhibitors use, and risk of acute kidney injury: a meta-analysis of observational studies

“…The association between PPIs use and CKD was shown by several studies,14,16,28 and the association was more pronounced in patients using higher doses of PPI 14. Lazarus et al14 and Xie et al16 conducted three cohort studies and found 1.22- to 1.50-fold increased risk of CKD for PPI users versus non-PPI users, and a 1.28- to 1.39-fold for PPI users versus H 2 receptor antagonist users 14,16.…”

Acid‐suppressive drugs and risk of kidney disease: A systematic review and meta‐analysis

“…Among the included studies, five were case–control studies, and the remaining five were cohort studies, involving 128 020 KD patients. All studies evaluated the influence of ASDs on the risk of KD, with five studies evaluating both PPI and H 2 RA and another five studies evaluating only PPI.…”

Prevalence of chronic kidney disease in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…Studies have reported that CKD is an independent risk factor for cardiovascular disease [4]. In recent years, additional causes of CKD have been recognized such as unrecovered acute kidney injury (AKI) [5, 6] and use of proton pump inhibitors (PPIs) [7, 8], In this manuscript we analyze the association of CKD with COPD using the limited data available… Several studies have identified COPD as part of a systemic inflammatory syndrome [9–12] and reported on the association of comorbidities like lung cancer [13], osteoporosis [14], progression of atherosclerosis [15], and CKD. This systematic review was performed to assess the association of COPD with CKD.…”