Kidney Week

Abstract: FR-PO166

Discontinuation of Proton Pump Inhibitors in Patients with CKD

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Mertz, Amanda, Northeast Ohio VA Healthcare System, Cleveland, Ohio, United States

Amanda Mertz,

• Cooney, Danielle N., Northeast Ohio VA Healthcare System, Cleveland, Ohio, United States

Danielle N. Cooney,

• Rahman, Mahboob, Case Western Reserve University, Cleveland, Ohio, United States

Mahboob Rahman,

• Lacey, Chirstopher S., Northeast Ohio VA Healthcare System, Cleveland, Ohio, United States

Chirstopher S. Lacey,

• Burant, Christopher J., Northeast Ohio VA Healthcare System, Cleveland, Ohio, United States

Christopher J. Burant,

• Desai, Niraj, Case Western Reserve University, Cleveland, Ohio, United States

Niraj Desai,

Background

Proton pump inhibitors (PPIs) are commonly used medications in the US and are historically well tolerated. Recent studies have linked PPI use to development of chronic kidney disease (CKD) and end-stage renal disease (ESRD). We investigated whether discontinuation of PPIs in patients with CKD results in slower kidney disease progression compared to patients who continued PPIs.

Methods

This is a retrospective chart review of patients with established CKD taking a PPI from January 1, 2014 to December 31, 2014. Patient’s eligible for inclusion were those with established CKD, defined as 2 eGFR measurements of < 60 ml/min/1.73m² at least 90 days apart, who were on a PPI from January 1, 2014 to December 31, 2014, with a medication possession ratio (MPR) of ≥70%. Patients were excluded if they were on dialysis at baseline and did not have baseline and final eGFR measurements. We compared baseline eGFR to a final eGFR after at least 6 months of discontinuation or continuation of a PPI.

Results

100 patients in the PPI discontinuation group and 97 patients in the PPI continuation group met study inclusion criteria. Baseline renal function in the PPI continuation group was eGFR of 47.9 ml/min/1.73 m² and 50.7 ml/min/1.73 m² in the PPI discontinuation group. Final eGFR in the PPI continuation group was significantly higher at 51.1 ml/min/1.73m² (p=0.01). Final eGFR in the PPI discontinuation group was 51.8 ml/min/1.73m² (p=0.3). The average time between baseline and final eGFRs was 270 days in the PPI continuation group and 301 days in the PPI discontinuation group. There was no statistically significant difference in the change in eGFRs between groups (95% CI -5.48-2.03; p=0.37).

Conclusion

Discontinuing a PPI after one year of continuous use in patients with CKD did not impact change in renal function after one year.