Abstract: SA-PO888
Association Between Proton-Pump Inhibitors and CKD in Japanese Patients
Session Information
- CKD: Pharmacoepidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Horino, Taro, Kochi Medical School, Kochi University, Kochi, Japan
- Hatakeyama, Yutaka, Kochi medical school, Nankoku-shi, Kochi, Japan
- Nagata, Keitaro, Kochi University, Nankoku, Japan
- Matsumoto, Tatsuki, Kochi University, Nankoku, Japan
- Terada, Yoshio, Kochi Medical School, Nankoku-city, Japan
- Okuhara, Yoshiyasu, Kochi Medical School, Nankoku-city, Japan
Background
Proton-pump inhibitor (PPI) use has been reported to be a risk factor for chronic kidney disease (CKD), potentially mediated by recurrent acute kidney injury (AKI). We aimed to estimate the progress rate of renal dysfunction in patients taking PPI in real clinical settings and to compare the results with those of patients taking histamine-2 receptor antagonist (H2RA) and those taking neither PPI nor H2RA.
Methods
We retrospectively reviewed patients’ data collected from Kochi Medical School Hospital’s information system between 2001 and 2017. Patients were classified into the PPI, H2RA, and CONT (control patients without PPI/H2RA use) groups, and their data were compared. Survival time was defined as the time between drug administration date (zero hour) and a 30% decrease in estimated glomerular filtration rate (eGFR; primary endpoint).
Results
We initially evaluated 92,585 Japanese individuals. According to the study protocol, the final analysis evaluated data of 5,849 patients, including 3,211 patients in the PPI group and 2,638 patients in the H2RA group. The mean age was 58±18.5, 67.4±14.1, and 63.8±15.8 years for the CONT, PPI, and H2RA groups, respectively. On survival analysis, the PPI and H2RA groups had a significantly higher survival rate (p<0.001) than the CONT group, whereas no significant difference was found between the PPI and H2RA groups. When the CONT group was set as a reference, PPI use, or H2RA use were associated with high HRs at 1.2861, and 1.5437, respectively. Frequencies of male sex, older age, CKD (G3a, G3b, G4), and diabetes mellitus (DM) were significantly higher in the PPI group, followed by the H2RA group, then the CONT group. Our cohort had higher frequencies of male sex, older age, DM, and AKI history, associated with high HRs at 1.1015, 1.025, 1.219, or 12.7142, respectively.
Conclusion
PPI or H2RA use was significantly associated with an increased risk of CKD development. H2RA use was associated with CKD development. PPI or H2RA users may include patients with CKD risk factors. Given that CKD risk was not different between Japanese PPI and H2RA users, PPIs may not be more involved in CKD development than H2RAs.