Proton pump inhibitors are associated with increased risk of development of chronic kidney disease.
Proton pump inhibitors are associated with increased risk of development of chronic kidney disease.
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DOI：
10.1186/s12882-016-0325-4
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发表时间：
2016-08-03
期刊：
影响因子：
2.3
通讯作者：
Lohr JW
中科院分区：
文献类型：
--
作者：
Arora P;Gupta A;Golzy M;Patel N;Carter RL;Jalal K;Lohr JW
急性间质性肾炎继发于质子泵抑制剂（PPIs），由于其亚急性的临床表现，可能后来表现为慢性肾脏疾病（CKD），经常无法诊断。我们调查了PPI使用与CKD发展和死亡的关系。采用两个独立的回顾性病例对照研究设计，对数据进行前瞻性logistic回归分析，以评估CKD的发展和死亡与PPI使用的关系。研究对象包括2001年4月至2008年4月在VISN2初级保健诊所就诊的99269名患者。为了评估CKD结果，在纽约北部退伍军人事务医疗保健（VISN2）网络数据系统中首次观察的22,807例既往CKD患者被排除在外。获得的数据包括PPI的使用（是/否）、人口统计学、实验室数据、PPI前合并症变量。共有19,311/76,462例患者发展为CKD。在发生CKD的患者中，24.4%使用PPI。接受PPI治疗的患者患血管疾病、慢性阻塞性肺病、癌症和糖尿病的可能性较低。在99269例死亡结果分析患者中，11758例死亡。病例对照数据的前瞻性逻辑分析显示，服用PPIs的患者发生CKD的几率（OR 1.10, 95% CI 1.05-1.16）和死亡率（OR 1.76, 95% CI 1.67-1.84）高于未服用PPIs的患者。使用质子泵抑制剂与CKD发展和死亡风险增加相关。由于大量患者正在接受质子泵抑制剂的治疗，医疗保健提供者需要更好地了解这些药物的潜在副作用。
Acute interstitial nephritis secondary to proton pump inhibitors (PPIs) frequently goes undiagnosed due to its subacute clinical presentation, which may later present as chronic kidney disease (CKD). We investigated the association of PPI use with the development of CKD and death. Two separate retrospective case–control study designs were employed with a prospective logistic regression analysis of data to evaluate the association of development of CKD and death with PPI use. The population included 99,269 patients who were seen in primary care VISN2 clinics from 4/2001 until 4/2008. For evaluation of the CKD outcome, 22,807 with preexisting CKD at the first observation in Veterans Affairs Health Care Upstate New York (VISN2) network data system were excluded. Data obtained included use of PPI (Yes/No), demographics, laboratory data, pre-PPI comorbidity variables. A total of 19,311/76,462 patients developed CKD. Of those who developed CKD 24.4 % were on PPI. Patients receiving PPI were less likely to have vascular disease, COPD, cancer and diabetes. Of the total of 99,269 patients analyzed for mortality outcome, 11,758 died. A prospective logistic analysis of case–control data showed higher odds for development of CKD (OR 1.10 95 % CI 1.05–1.16) and mortality (OR 1.76, 95 % CI 1.67–1.84) among patients taking PPIs versus those not on PPIs. Use of proton pump inhibitors is associated with increased risk of development of CKD and death. With the large number of patients being treated with proton pump inhibitors, healthcare providers need to be better educated about the potential side effects of these medications.