Abstract: PO2585
Proton Pump Inhibitor Prevalence and Documented Indication in a Small Kidney Transplant Program
Session Information
- Transplant Complications: Glomerular Disease and Genetics
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Alkandari, Abdulrahman, Queen's University, Kingston, Ontario, Canada
- Macleod, Frances, Queen's University, Kingston, Ontario, Canada
- Shamseddin, M. Khaled, Queen's University, Kingston, Ontario, Canada
Background
Proton pump inhibitors (PPIs) are commonly prescribed post kidney transplantation, and their use was prevalent in 44-48% of recipients. Prolonged exposure to PPIs could be associated with renal and non-renal adverse outcomes, including hypomagnesemia and hip fracture (OR: 1.39, 95% CI: 1.04-1.84). The objective of this report is to evaluate the prevalence and the documented indication of PPI use in our kidney transplant program, while exploring the potential PPI withdrawal and GERD recurrence in a future Quality Improvement (QI) project.
Methods
This is a retrospective study to assess the prevalence and the documented indications of PPI use among all of kidney transplant recipients in our program by March 31st, 2020. The primary variables were the prevalence of PPI use and the percentage of patients with documented indication of PPI use in our Health Information System (HIS).
Results
Out of 202 kidney transplant recipients, 113 (55.9%) patients were on PPIs (Mean age 58 years, Male 68 (60.2%), mean post-transplant longevity 106 months), compared with 12 (5.9%) patients on H2 blockers. Thirty three (29.2%) patients who used to be on H2 blockers were switched to PPI in late 2019 due to contaminated and backordered ranitidine resulting in an adjusted prevalence of PPI use of 39.5% (Figure 1). The indication of PPI use was documented in our HIS as gastro-esophageal reflux disease (GERD) in 53 (46.9%) patients, and as peptic ulcer disease (PUD) in 9 (8%) patients, while its indication was undocumented in 51 (45.1%) patients.
Conclusion
PPI use was prevalent among our kidney transplant recipients similar to other studies. Due to its association with multiple adverse outcomes, better documentation of its indication in the medical record is required. Consideration to withdraw PPI in our kidney transplant recipients and to reassess the risk of GERD recurrence will be assessed in a future QI project.