Association between proton pump inhibitor use and risk of progression of chronic kidney disease

摘要: Background & Aims Proton pump inhibitors (PPI) have been associated with acute kidney injury and recent studies suggest that they may be the risk of chronic disease (CKD). Methods We performed a retrospective analysis using Stockholm creatinine measurements database, which contains information on diagnoses, dispensation claims, laboratory test results for all citizens in region from 2007 through 2010. identified new users PPIs (n = 105,305) H 2 blockers (H B; n = 9578); data renal outcomes were collected median 2.7 years. The primary outcome was progression CKD, defined as doubling or decrease estimated glomerular filtration rate 30% more. Secondary end-stage injury. Complete collection repeated PPI B dispensations at pharmacies Sweden allowed modeling time-dependent cumulative exposure. Results Users PPIs, compared Bs, had an increased doubled levels (1985 events; adjusted hazard ratio [HR], 1.26; 95% CI, 1.05–1.51) more (11,045 1.16–1.36). use also development (HR, 2.40; 0.76–7.58) 1.30; 1.00–1.69). There graded association between exposure to CKD progression. This not case use. Conclusions Initiation therapy is associate large, North European healthcare system. Although consistent, modest magnitude, cannot exclude residual confounding.