Skip to main content
Erschienen in: International Urology and Nephrology 10/2018

13.06.2018 | Nephrology - Review

The use of anti-ulcer agents and the risk of chronic kidney disease: a meta-analysis

verfasst von: Jing Sun, Hongjun Sun, Meiyu Cui, Zhijian Sun, Wenyue Li, Jianxin Wei, Shuhua Zhou

Erschienen in: International Urology and Nephrology | Ausgabe 10/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We conducted a meta-analysis to explore the association between the use of different anti-ulcer agents and the risk of chronic kidney disease (CKD), end-stage renal disease (ESRD), and decline in glomerular filtration rate (GFR) in various study populations.

Methods

PubMed, Embase, and the Cochrane Library were searched for relevant entries up to July 1, 2017. The primary outcomes of the meta-analysis were risk ratios (RRs) of CKD, ESRD, and decline in GFR. We also investigated the heterogeneity of the meta-analysis by subgroup analysis and meta-regression analysis.

Results

A total of 662,624 individuals were enrolled in five trials. Compared with non-PPI users, PPI users had a higher trend of CKD (RR = 1.16, 95% CI 1.07–1.25, P < 0.001), especially ESRD (RR = 1.81, 95% CI 1.59–2.06, P < 0.001). There was an elevated risk of adverse renal outcome among participants receiving PPI and not H2RA (CKD: RR = 1.28, 95% CI 1.24–1.33, P < 0.001; ESRD: RR = 1.39, 95% CI 1.17–1.64, P < 0.001; GFR: RR = 1.31, 95% CI 1.26–1.36, P < 0.001). However, H2RA users were not associated with CKD when compared with non-H2RA users (RR = 1.02, 95% CI 0.83–1.25, P = 0.855). In subgroup analysis, the average age of individuals and drug dosage had no influence on the risk of CKD, while duration of PPI exposure from 31 to 720 days is a potential factor in progression to ESRD (P < 0.001).

Conclusions

Chronic PPI use, but not H2RAs, is associated with deterioration in kidney function.
Literatur
2.
Zurück zum Zitat Alhazzani W, Guyatt G, Alshahrani M, Deane AM, Marshall JC, Hall R, Muscedere J, English SW, Lauzier F, Thabane L, Arabi YM, Karachi T, Rochwerg B, Finfer S, Daneman N, Alshamsi F, Zytaruk N, Heel-Ansdell D, Cook D (2017) Withholding pantoprazole for stress ulcer prophylaxis in critically ill patients: a pilot randomized clinical trial and meta-analysis. Crit Care Med 45(7):1121–1129. https://doi.org/10.1097/ccm.0000000000002461 CrossRefPubMed Alhazzani W, Guyatt G, Alshahrani M, Deane AM, Marshall JC, Hall R, Muscedere J, English SW, Lauzier F, Thabane L, Arabi YM, Karachi T, Rochwerg B, Finfer S, Daneman N, Alshamsi F, Zytaruk N, Heel-Ansdell D, Cook D (2017) Withholding pantoprazole for stress ulcer prophylaxis in critically ill patients: a pilot randomized clinical trial and meta-analysis. Crit Care Med 45(7):1121–1129. https://​doi.​org/​10.​1097/​ccm.​0000000000002461​ CrossRefPubMed
5.
Zurück zum Zitat MacLaren R, Campbell J (2014) Cost-effectiveness of histamine receptor-2 antagonist versus proton pump inhibitor for stress ulcer prophylaxis in critically ill patients. Crit Care Med 42(4):809–815CrossRefPubMed MacLaren R, Campbell J (2014) Cost-effectiveness of histamine receptor-2 antagonist versus proton pump inhibitor for stress ulcer prophylaxis in critically ill patients. Crit Care Med 42(4):809–815CrossRefPubMed
9.
Zurück zum Zitat Zhu W, Hong K (2017) Potential cardiovascular risks of proton pump inhibitors in the general population. Int Heart J 58(2):163–166CrossRefPubMed Zhu W, Hong K (2017) Potential cardiovascular risks of proton pump inhibitors in the general population. Int Heart J 58(2):163–166CrossRefPubMed
11.
Zurück zum Zitat Moledina DG, Perazella MA (2017) Drug-induced acute interstitial nephritis. Clin J Am Soc Nephrol 60(2):804–817 Moledina DG, Perazella MA (2017) Drug-induced acute interstitial nephritis. Clin J Am Soc Nephrol 60(2):804–817
17.
Zurück zum Zitat Leonard CE, Freeman CP, Newcomb CW, Reese PP, Herlim M, Bilker WB, Hennessy S, Strom BL (2012) Proton pump inhibitors and traditional nonsteroidal anti-inflammatory drugs and the risk of acute interstitial nephritis and acute kidney injury. Pharmacoepidemiol Drug Saf 21(11):1155–1172. https://doi.org/10.1002/pds.3329 CrossRefPubMed Leonard CE, Freeman CP, Newcomb CW, Reese PP, Herlim M, Bilker WB, Hennessy S, Strom BL (2012) Proton pump inhibitors and traditional nonsteroidal anti-inflammatory drugs and the risk of acute interstitial nephritis and acute kidney injury. Pharmacoepidemiol Drug Saf 21(11):1155–1172. https://​doi.​org/​10.​1002/​pds.​3329 CrossRefPubMed
22.
Zurück zum Zitat Nochaiwong S, Ruengorn C, Awiphan R, Koyratkoson K, Chaisai C, Noppakun K, Chongruksut W, Thavorn K (2017) The association between proton pump inhibitor use and the risk of adverse kidney outcomes: a systematic review and meta-analysis. Nephrol Dial Transplant. https://doi.org/10.1093/ndt/gfw470 CrossRef Nochaiwong S, Ruengorn C, Awiphan R, Koyratkoson K, Chaisai C, Noppakun K, Chongruksut W, Thavorn K (2017) The association between proton pump inhibitor use and the risk of adverse kidney outcomes: a systematic review and meta-analysis. Nephrol Dial Transplant. https://​doi.​org/​10.​1093/​ndt/​gfw470 CrossRef
Metadaten
Titel
The use of anti-ulcer agents and the risk of chronic kidney disease: a meta-analysis
verfasst von
Jing Sun
Hongjun Sun
Meiyu Cui
Zhijian Sun
Wenyue Li
Jianxin Wei
Shuhua Zhou
Publikationsdatum
13.06.2018
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 10/2018
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-018-1908-8

Weitere Artikel der Ausgabe 10/2018

International Urology and Nephrology 10/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.