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Long-term continuous use of proton-pump inhibitors is associated with renal function decline in patients without acute kidney injury

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Abstract

Background

Proton-pump inhibitors (PPIs) are widely used to treat gastroesophageal reflex disease, peptic ulcer disease, and stress ulcer prophylaxis. This study estimated the progress rate of renal dysfunction in patients taking PPIs in clinical settings and compared the results with those of patients taking histamine-2 receptor antagonists (H2RAs).

Methods

We retrospectively reviewed patients’ data collected from Kochi Medical School Hospital’s information system between 2001 and 2019. Patients were classified into PPI and H2RA groups, and survival time was defined as the period between initial drug administration and a 30% decrease in estimated glomerular filtration rate (eGFR).

Results

On survival analysis, the PPI group was associated with higher event incidence rates compared to that in the H2RA group. The rate of underlying disease was significantly higher in the PPI group than in the H2RA group, with no significant differences in age and sex between the groups. Comparing the PPI group to the H2RA group, the use of aspirin, clopidogrel, statin, and angiotensin II receptor blocker was significantly higher, whereas the use of non-steroidal anti-inflammatory drugs and steroids was significantly less. Regarding survival rate and 30% decrease in eGFR, the PPI group had a significantly higher survival rate compared to that in the H2RA group at 730 days, but not earlier. PPI use, older age, and eGFR ≥ 90 mL/min/1.73 m2 exhibited high hazard ratios.

Conclusions

PPI use was significantly associated with an increased risk of chronic kidney disease development compared to that with H2RA use.

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Authors and Affiliations

  1. Center of Medical Information Science, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Japan

    Yutaka Hatakeyama & Yoshiyasu Okuhara

  2. Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan

    Taro Horino, Tatsuki Matsumoto & Yoshio Terada

Authors
  1. Yutaka Hatakeyama
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  2. Taro Horino
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  3. Tatsuki Matsumoto
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  4. Yoshio Terada
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  5. Yoshiyasu Okuhara
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Corresponding author

Correspondence to Taro Horino.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed this study were in accordance with the ethical standards of and approved by the ethical review board of Kochi Medical School (approval No. 23-15) and were conducted in accordance with the 1964 Helsinki Declaration and its later amendments.

Informed consent

All patient data were obtained from the hospital’s central clinical data warehouse (the Retrieval System for Open Medical Analysis 2 warehouse) with general consent from patients through the opt-out policy of the Kochi Medical School Hospital.

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Hatakeyama, Y., Horino, T., Matsumoto, T. et al. Long-term continuous use of proton-pump inhibitors is associated with renal function decline in patients without acute kidney injury. Clin Exp Nephrol 25, 1087–1092 (2021). https://doi.org/10.1007/s10157-021-02066-z

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  • DOI: https://doi.org/10.1007/s10157-021-02066-z

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