Key result
Regular PPI use linked to faster eGFR decline and borderline ~29% higher incident CKD risk.
Why the study?
The study was conducted to investigate the longitudinal association of use and duration of use of proton pump inhibitors with the incidence of chronic kidney disease and kidney function change.
Does proton pump inhibitor use increase the risk of incident chronic kidney disease and kidney function decline in adults?
Cohort (n=13,909)
Yes
Does proton pump inhibitor use increase the risk of incident chronic kidney disease and kidney function decline in adults?
Odds Ratio: 1.29 (95% CI 0.97–1.71)
Absolute Event Rate: 6.5% vs 3.6%
p-value: p=0.079
Use of proton pump inhibitors, particularly for more than six months, is associated with an increased risk of incident chronic kidney disease and accelerated decline in kidney function.
OBJECTIVE: Investigate the longitudinal association of use and time of use of proton pump inhibitors (PPI) with incidence of chronic kidney disease (CKD) and kidney function change. METHODS: Prospective study with 13,909 participants from baseline (2008-2010) and second wave (2012-2014) of the ELSA-Brasil (mean interval between visits = 3.9 years (1.7-6.0)). Participants answered about use and time use of the PPI in the two weeks prior the interview. Renal function was assessed by glomerular filtration rate estimated by the Collaboration Equation for the Epidemiology of Chronic Kidney Disease. Values below 60ml/min/1.73 m² in wave 2 were considered incident CKD. Associations between PPI use and time of use at baseline and incident CKD and decline in renal function were estimated, respectively, by logistic regression and linear models with mixed effects, after adjusting for confounders. RESULTS: After adjustments, PPI users for more than six months had an increased risk of CKD compared to non-users. Compared to non-users, users PPIs for up to six months and above six months had greater decline in kidney function over time. CONCLUSION: This cohort of adults and elderly, after a mean interval of 3.9 years, PPI use and initial duration were associated with kidney function change between visits.
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Santos et al. (2023) conducted a cohort in Kidney function decline and incident chronic kidney disease (n=13,909). Proton pump inhibitors vs. Non-users was evaluated on Incident chronic kidney disease (CKD) (OR 1.29, 95% CI 0.97-1.71, p=0.079). Regular exposure to proton pump inhibitors was associated with a more pronounced decline in estimated glomerular filtration rate and a borderline increased risk of incident chronic kidney disease (OR 1.29) compared to non-users.
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