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PPIs and the Risk of Chronic Kidney Disease
What is the association?
Protein pump inhibitor (PPI) use was associated with a higher risk of incident chronic kidney disease (CKD) in a study of 10,482 participants who took part in the Atherosclerosis Risk in Communities (ARIC) study. The mean age of participants was 63 years, and 43.9% were male. Researchers found:
• Compared with nonusers, PPI users were more often of white race, obese, and taking antihypertensive medication.
• PPI use was associated with incident CKD in unadjusted analysis (HR, 1.45), in analysis adjusted for demographic, socioeconomic, and clinical variables (HR, 1.50), and in analysis with PPI ever use modeled as a time-varying variable (HR, 1.35).
• The association persisted when baseline PPI users were compared directly with H2 receptor antagonist users (aHR, 1.39) and with propensity score-matched nonusers (HR, 1.76).
• In a replication cohort, PPI use was associated with CKD in all analyses.
• Twice-daily PPI dosing was associated with a higher risk than once-daily dosing (aHR, 1.46 vs 1.15).
Citation: Lazarus B, Chen Y, Wilson FP, et al. Proton pump inhibitor use and the risk of chronic kidney disease. [Published online ahead of print January 11, 2016]. JAMA Intern Med. doi: 10.1001/jamainternmed.2015.7193.
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