Adverse outcomes of proton pump inhibitors in patients with chronic kidney disease: The CKD‐REIN cohort study
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- Sophie Liabeuf
- Department of Clinical Pharmacology Amiens University Hospital Amiens France
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- Oriane Lambert
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
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- Marie Metzger
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
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- Aghiles Hamroun
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
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- Maurice Laville
- Nephrology Department Lyon Sud Hospital Pierre Benite France
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- Solène M. Laville
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
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- Luc Frimat
- Nephrology Department Nancy University Hospital Vandoeuvre‐lès‐Nancy France
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- Roberto Pecoits‐Filho
- Arbor Research Collaborative for Health Ann Arbor Michigan USA
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- Denis Fouque
- Nephrology Department, Centre Hospitalier Lyon Sud Université de Lyon Carmen Pierre‐Bénite France
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- Ziad A. Massy
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
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- Christian Jacquelinet
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
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- Bénédicte Stengel
- Centre for Research in Epidemiology and Population Health (CESP), Paris‐Saclay University Paris Sud University, Versailles Saint Quentin University, INSERM France
書誌事項
- 公開日
- 2021-01-19
- 権利情報
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- http://onlinelibrary.wiley.com/termsAndConditions#vor
- DOI
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- 10.1111/bcp.14713
- 公開者
- Wiley
この論文をさがす
説明
<jats:sec><jats:title>Aims</jats:title><jats:p>Long‐term use of proton pump inhibitors (PPIs) has been associated with adverse kidney events in the general population, but their impact among chronic kidney disease (CKD) patients is unclear. We studied the prevalence and incidence (new users) of PPI prescriptions and their relation to kidney outcomes and mortality in CKD patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We collected drug prescriptions prospectively in a cohort of 3023 nephrology outpatients with CKD stages 2–5 at inclusion. Hazard ratios (HR, 95% confidence intervals [95% CI]) for acute kidney injury (AKI), end‐stage kidney disease (ESKD), and mortality associated with new PPI prescriptions as a time‐dependent variable were estimated with cause‐specific Cox models in 1940 non‐users with eGFR ≥ 15 mL/min/1.73 m<jats:sup>2</jats:sup> at baseline, adjusted for comorbidities, laboratory data and drugs.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>There were 981/3023 (32%) prevalent users (67 ± 13 years, 65% men) at baseline, and 366/3023 (12%) were prescribed PPI (new users) over a median follow‐up of 3.9 years (interquartile range, 3–4.2). Among these new users, their median cumulative duration of prescription was 1 year (interquartile range: 0.4–2.3). During follow‐up, 354 patients developed ESKD and 216 died before ESKD. The adjusted HRs associated with PPI prescription were 1.74 (95% CI, 1.26–2.40) for ESKD and 2.42 (95% CI, 1.73–3.39) for all‐cause mortality. Over the first 3 years of follow‐up, 211 AKI events had occurred. The adjusted HR for AKI associated with PPI prescription was 2.89 (95% CI, 1.91–4.38).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Long‐term PPI prescription was common in CKD patients. Our results call attention to its potential risks of both acute and chronic kidney failure.</jats:p></jats:sec>
収録刊行物
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- British Journal of Clinical Pharmacology
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British Journal of Clinical Pharmacology 87 (7), 2967-2976, 2021-01-19
Wiley
