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Proton Pump Inhibitors Augment the Risk of Major Adverse Cardiovascular Events and End‐Stage Renal Disease in Patients With Acute Kidney Injury After Temporary Dialysis
Author(s) -
Tsai IJung,
Lai TaiShuan,
Shiao ChihChung,
Huang TaoMin,
Wang ChihHsien,
Tsao Chun-Hao,
Chen Liang-Wen,
Lin YenHung,
Chen Likwang,
Wu VinCent,
Chu TzongShinn
Publication year - 2020
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.1762
Subject(s) - medicine , acute kidney injury , dialysis , mace , end stage renal disease , kidney disease , adverse effect , incidence (geometry) , propensity score matching , confidence interval , relative risk , disease , intensive care medicine , percutaneous coronary intervention , myocardial infarction , physics , optics
Proton pump inhibitors (PPIs) have been reported to increase the risk of acute and chronic renal disease. However, the data are unclear in patients with acute kidney injury (AKI) requiring dialysis (AKI‐D) who are often candidates for PPIs. To investigate this important issue, we identified 26,052 AKI‐D patients from Taiwan’s National Health Insurance Research Database weaning from dialysis. During a mean follow‐up period of 3.52 years, the PPI users had a higher incidence of end‐stage renal disease (ESRD) than the PPI nonusers ( P < 0.001). After propensity score matching and treating mortality as a competing risk factor, the PPI users had a higher risk of ESRD (subhazard ratio (sHR) 1.40; 95% confidence interval (CI), 1.31–1.50) and major adverse cardiac events (MACE, sHR 1.53; 95% CI, 1.37–1.71) compared with the PPI nonusers with AKI‐D survivors. In conclusion, the use of PPIs was associated with a higher risk of ESRD and MACE, compared with the PPI nonusers in AKI‐D patients who weaned from dialysis.