000150569 001__ 150569
000150569 005__ 20251017144650.0
000150569 0247_ $$2doi$$a10.1007/s11606-024-09213-8
000150569 0248_ $$2sideral$$a142664
000150569 037__ $$aART-2024-142664
000150569 041__ $$aeng
000150569 100__ $$aGonzález-Pérez, Antonio
000150569 245__ $$aProton Pump Inhibitor Use and Worsening Kidney Function: A Retrospective Cohort Study Including 122,606 Acid-Suppressing Users
000150569 260__ $$c2024
000150569 5060_ $$aAccess copy available to the general public$$fUnrestricted
000150569 5203_ $$aBackground: The impact of proton pump inhibitors (PPIs) use on worsening renal function is controversial and lacks a solid pathophysiological explanation. Objective: To assess the risk of worsening renal function and acute kidney injury (AKI) in PPI initiators as compared with H2-blockers initiators. Design: Retrospective cohort study using longitudinal records from BIGAN, a population-based health database of Aragón (Spain). Participants:
PPIs (n = 119,520) and H2-blockers (n = 3,086) initiators between 2015 and 2020 with preserved renal function. They were followed until the occurrence of an adverse kidney event, death, lost to follow-up or June 2021.
Main measures: Primary endpoints were worsening kidney function (measured as sCr ≥ 2 times baseline, eGFR < 60 ml/min/1.73m2, a decrease in eGFR 30–50% from baseline or end stage renal disease) and AKI (measured by Aberdeen algorithm or hospitalization due to AKI). Incidence rates (IRs) per 1,000 persons-years were reported and Cox regression was used to calculate Hazard ratios (HRs), adjusted for confounders. Key results: Crude IRs for worsening kidney function were consistently lower for ranitidine than for PPIs (eGFR < 60 ml/min/1.73m2: IR 18.7 95%CI (12.0–27.8) for ranitidine, IR 31.2 95%CI (29.9–32.5) for omeprazole). However, the risk of incident worsening function did not significantly differ in the Cox regression analysis adjusting for confounders (HR 0.99 95%CI (0.66–1.48) for omeprazole, as compared to ranitidine). PPI initiators consistently showed lower IRs of AKI using Aberdeen algorithm (IR 33.8 95%CI (32.4–35.1) for omeprazole, IR 52.8 95%CI (40.9–67.1) for ranitidine) and lower risk of AKI (HR 0.54 95%CI (0.42–0.70) for omeprazole, as compared to ranitidine). Conclusions: No clinically relevant differences were observed for worsening kidney function between PPIs and H2-blockers initiators. PPIs users presented a reduced risk of AKI compared to ranitidine initiators. Graphical Abstract: AKI: acute kidney injury. eGFR: estimated glomerular filtrate rate. H2-blocker: Histamine 2 receptor antagonist. PPI: proton pump inhibitor. sCr: serum creatinine.
000150569 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000150569 590__ $$a4.2$$b2024
000150569 592__ $$a1.992$$b2024
000150569 591__ $$aMEDICINE, GENERAL & INTERNAL$$b42 / 332 = 0.127$$c2024$$dQ1$$eT1
000150569 593__ $$aInternal Medicine$$c2024$$dQ1
000150569 591__ $$aHEALTH CARE SCIENCES & SERVICES$$b25 / 185 = 0.135$$c2024$$dQ1$$eT1
000150569 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000150569 700__ $$aMartínez-Domínguez, Samuel J.$$uUniversidad de Zaragoza
000150569 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, Ángel$$uUniversidad de Zaragoza
000150569 700__ $$aLanas, Aitor
000150569 700__ $$0(orcid)0000-0003-1420-5499$$aIñigo, Pablo$$uUniversidad de Zaragoza
000150569 700__ $$aGarcía-Rodríguez, Luis A.
000150569 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000150569 773__ $$g40 (2024), 818-827$$pJ. gen. intern. med.$$tJOURNAL OF GENERAL INTERNAL MEDICINE$$x0884-8734
000150569 8564_ $$s1226773$$uhttps://zaguan.unizar.es/record/150569/files/texto_completo.pdf$$yVersión publicada
000150569 8564_ $$s2722541$$uhttps://zaguan.unizar.es/record/150569/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000150569 909CO $$ooai:zaguan.unizar.es:150569$$particulos$$pdriver
000150569 951__ $$a2025-10-17-14:36:16
000150569 980__ $$aARTICLE