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Kidney Week

Abstract: SA-PO1124

Potassium-Competitive Acid Blocker Use and Risk of Incident CKD: Korean Nationwide Study

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Rhee, Harin, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Kim, Jinmi, Pusan National University Hospital, Busan, Korea (the Republic of)
Background

Tegoprazan is a potassium competitive acid blocker and novel and potent anti-acid medication. With increasing concerns regarding adverse kidney events associated with long-term use of proton pump inhibitors (PPI), the use of tegoprazan is rapidly increasing worldwide. However, its effect on the incidence of chronic kidney disease (CKD) has not been evaluated.

Methods

Using the Korean Health Insurance Review and Assessment database encoded by the Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM), patients with no kidney disease who initiated tegoprazan, PPIs, or histamine-2 receptor antagonists (H2RAs) for > 90 days were enrolled from 2013–2022. The incidences of CKD events between tegoprazan and H2RAs, tegoprazan and PPIs, and PPIs and H2RAs were compared using a Cox proportional hazards model, and the results were combined using a network meta-analysis.

Results

After 1:1 propensity score matching, a total of 45,656, 50,346, and 628,147 pairs of patients were independently analyzed for the incidence of CKD. One-third of the patients were aged > 65 years, > 50% had hypertension, and 20–25% had diabetes. In the network meta-analysis based on three independent comparisons, the risk of incident CKD was significantly higher with PCABs than with H2RAs (hazard ratio [HR] 1.136 [1.047–1.233]) and PPIs (HR; 1.089 (1.004–1.182]) (Fig.1).

Conclusion

In this real-world study, tegoprazan prescription for > 90 days was associated with a 14% and 9% higher risk of CKD development than H2RAs and PPIs, respectively. Alerts regarding kidney function monitoring are required until new evidence emerges.

Digital Object Identifier (DOI)