Using proton pump inhibitors correlates with an increased risk of chronic kidney disease: a nationwide database-derived case-controlled study

Hung, Shih-Chang; Liao, Kuan‐Fu; Hung, Hung-Chang; Lin, Cheng‐Li; Lai, Shih‐Wei; Lee, Po-Chang; Hung, Shih-Rong

doi:10.1093/fampra/cmx102

Cited by 38 publications

(30 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hung et al [16] claimed that the OR for CKD is 1.41 (CI 1.34, 1.48) for subjects using PPIs. Besides, the odds ratio of CKD in relation to the cumulative duration of different proton pump inhibitor is also clearly announced.…”

Section: Discussionmentioning

confidence: 99%

Proton pump inhibitors use and risk of chronic kidney disease in diabetic patients

Yang

Juang²,

Liao

2019

Diabetes Research and Clinical Practice

Self Cite

View full text Add to dashboard Cite

Chronic kidney disease consumes a huge amount of medical resources and proton pump inhibitors may be a potential factor for the increasing prevalence. This populationbased cohort study investigates the risk of chronic kidney disease in a diabetic population using proton pump inhibitors in Taiwan. Methods: This study is based on a specific diabetic database obtained from the National Health Insurance Research Database. Individuals with a new diagnosis of diabetes from 2002 to 2013 were enrolled. ''Exposure" to proton pump inhibitors was defined as at least one prescription and dosage over 180 DDD (defined daily dose) in one year after the index date. A multivariable Cox proportional hazard model and competing-risk regression model were applied. Results: There were 5994 patients in the final cohort of proton pump inhibitor users and 23,976 patients in the matched controlled cohort based on 1:4 propensity score matching. Compared with no exposure users, PPIs exposure group had more anemia prevalence, antihypertension medication and NSAIDs prescriptions. The multivariable Cox proportional hazard model showed that the adjusted hazard ratio of chronic kidney disease was 1.52 (95% CI 1.40-1.65) in diabetic individuals with PPIs exposure, compared with no exposure users. Conclusions: Proton pump inhibitors use is associated with 1.52-fold increased risk of chronic kidney disease in diabetic patients when the dosage is over 180 DDD in one year in Taiwan.

show abstract

Section: Discussionmentioning

confidence: 99%

Proton pump inhibitors use and risk of chronic kidney disease in diabetic patients

Yang

Juang²,

Liao

2019

Diabetes Research and Clinical Practice

Self Cite

View full text Add to dashboard Cite

show abstract

“…Another study that reported a weaker association of PPI use with CKD was conducted in Taiwan [ 13 ]. This large case-controlled study included 16,704 patients aged 20 or above and had been diagnosed with CKD.…”

Section: Resultsmentioning

confidence: 99%

“…Hypotheses generated from false associations can become a potential source of discontinuation of an established drug treatment. For example, two studies [ 12 , 13 ] included in the review only reported a weak association of CKD with the PPI use. Both weak as well as strong associations could be explained by the risk of confounding [ 21 ] and thus have limited merit in establishing causality when compared to RCTs.…”

Section: Discussionmentioning

confidence: 99%

Investigating the association of proton pump inhibitors with chronic kidney disease and its impact on clinical practice and future research: a review

Cheema

2019

J of Pharm Policy and Pract

View full text Add to dashboard Cite

Background Proton pump inhibitors (PPIs) are used worldwide for the treatment of gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD). Although considered to be widely safe, PPIs have been associated with the potential risk of adverse effects such as infections including pneumonia and Clostridium difficile , malabsorption of vitamins and minerals, dementia and more recently with chronic kidney disease (CKD). Evidence including large cohort studies suggests that there is a greater risk of developing CKD in chronic users of PPIs. However, the association of CKD with PPI use reported in these studies is weak and does not establish a clear causality. This review aims to further investigate the association of CKD with PPI use by including studies with various study designs. Methods A literature search of published articles with no start date restrictions was undertaken in May 2018 in three electronic databases (PubMed, ScienceDirect, Google Scholar). Search terms included ‘Proton Pump Inhibitors’, ‘chronic kidney disease’, and ‘association’. Both observational and randomised controlled trials (RCTs) investigating the association of CKD with PPI use were eligible for inclusion. Results Ten observational studies with 1,005,899 patients contributed to the review. No experimental study was available for inclusion in the review. Of the included studies, six used a retrospective study design, while the rest were prospective (two) or a case-controlled studies (two). A large prospective cohort study with 144,032 patients conducted in the USA reported that PPI use compared to no PPI use was associated with an increased risk of CKD Hazard ratio [HR] 1.28; 95% Confidence Interval [CI] 1.22–1.34. However, the observational study design of this study together with other studies included in the review suggests that the strength of evidence associating PPI use with CKD is weak and does not establish true causality. Conclusions The current evidence related to the potential association of CKD with PPI use remains inconclusive in establishing true causality. Further prospective studies including randomised controlled trials and cohort studies would be required to confirm the findings reported in this review and to draw any conclusions.

show abstract

“…All comorbidities were diagnosed based on ICD-9 codes, which have been well assessed in previous studies. [21–24]…”

Section: Methodsmentioning

confidence: 99%

Real-world database investigating the association between diabetes mellitus and herpes zoster in Taiwan

2019

Self Cite

View full text Add to dashboard Cite

Little evidence is available about the correlation between diabetes mellitus and herpes zoster in Taiwan. This study aimed to investigate the correlation between diabetes mellitus and herpes zoster in Taiwan. A population-based cohort study was conducted using the database of Taiwan National Health Insurance Program. There were 27,369 subjects aged 20 to 84 years with newly diagnosed diabetes mellitus from 2000 to 2012 as the diabetes mellitus group and 107,705 sex- and age-matched subjects without diabetes mellitus as the nondiabetes mellitus group. The incidence of herpes zoster at the end of 2013 was estimated. The multivariable Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) of herpes zoster associated with diabetes mellitus. The overall incidence of herpes zoster was 1.16-fold higher in the diabetes mellitus group than the nondiabetes mellitus group (7.85 vs 6.75 per 1000 person-years, 95% CI 1.12–1.20). After adjustment for co-variables, the adjusted HR of herpes zoster was 1.17 for subjects with diabetes mellitus (95% CI 1.10–1.23), compared with subjects without diabetes mellitus. Patients with diabetes mellitus are associated with 1.17-fold increased risk for developing herpes zoster.

show abstract

Using proton pump inhibitors correlates with an increased risk of chronic kidney disease: a nationwide database-derived case-controlled study

Abstract: Using PPIs presented 1.4-fold higher odds of CKD in Taiwan health insurance claims data analysis.

Cited by 38 publications

References 18 publications

Proton pump inhibitors use and risk of chronic kidney disease in diabetic patients

Proton pump inhibitors use and risk of chronic kidney disease in diabetic patients

Investigating the association of proton pump inhibitors with chronic kidney disease and its impact on clinical practice and future research: a review

Real-world database investigating the association between diabetes mellitus and herpes zoster in Taiwan

Contact Info

Product

Resources

About