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

Abstract Background Those taking proton pump inhibitors (PPIs) might have a higher risk of acute kidney injury. The long-term safety, especially the PPI-associated chronic kidney disease (CKD) is the subsequent concern. Objective This study explores the potential relationship between using PPIs and...

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Bibliographic Details
Published in:Family practice 2018-03, Vol.35 (2), p.166-171
Main Authors: Hung, Shih-Chang, Liao, Kuan-Fu, Hung, Hung-Chang, Lin, Cheng-Li, Lai, Shih-Wei, Lee, Po-Chang, Hung, Shih-Rong
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Case-Control Studies
Databases, Factual
Female
Humans
Logistic Models
Male
Middle Aged
Proton Pump Inhibitors - adverse effects
Renal Insufficiency, Chronic - chemically induced
Renal Insufficiency, Chronic - epidemiology
Risk Assessment
Taiwan - epidemiology
Young Adult
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Summary:Abstract Background Those taking proton pump inhibitors (PPIs) might have a higher risk of acute kidney injury. The long-term safety, especially the PPI-associated chronic kidney disease (CKD) is the subsequent concern. Objective This study explores the potential relationship between using PPIs and CKD in Taiwan. Methods Using a database collated by the Taiwan National Health Insurance programme, we conducted a population-based case-controlled study to identify 16 704 cases of patients aged 20 years or older with newly diagnosed CKD between 2000 and 2013. 16 704 controls were randomly selected and were matched by sex, age and comorbidities. ‘Use’ of PPIs was defined as when subjects had received at least a prescription for PPIs before the index date. ‘Non-use’ was defined as subjects who had never received a prescription for PPIs before the index date. The odds ratio (OR) for CKD associated with the use of PPIs was estimated by a logistic regression model. Results The OR for CKD was 1.41 for subjects using PPIs [95% confidence interval (CI) 1.34, 1.48] compared with subjects who had never used PPIs. Almost all major types of PPIs present a weak association with increased odds of CKD in cumulative duration and dosage regression analysis. The OR in relation to cumulative duration (per month) of PPIs use was 1.02 (95% CI 1.01, 1.02) and the OR in relation to cumulative dosage (per microgram) of PPIs use was 1.23 (95% CI 1.18, 1.28). Conclusions Using PPIs presented 1.4-fold higher odds of CKD in Taiwan health insurance claims data analysis.
ISSN:0263-2136
1460-2229
DOI:10.1093/fampra/cmx102