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Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis.
Dig Dis Sci 2017; 62(10):2821-2827DD

Abstract

BACKGROUND/AIMS

The aim of this meta-analysis was to assess the risks of chronic kidney disease (CKD) and/or end-stage kidney disease (ESRD) in patients who are taking proton-pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs).

METHODS

Comprehensive literature review was conducted utilizing MEDLINE and EMBASE databases through April 2017 to identify all studies that investigated the risks of CKD or ESRD in patients taking PPIs/H2RAs versus those without PPIs/H2RAs. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42017067252).

RESULTS

Five studies with 536,902 participants were patients were identified and included in the data analysis. When compared with non-PPIs users, the pooled risk ratio (RR) of CKD or ESRD in patients with PPI use was 1.33 (95% CI 1.18-1.51). Pre-specified subgroup analysis (stratified by CKD or ESRD status) demonstrated pooled RRs of 1.22 (95% CI 1.14-1.30) for association between PPI use and CKD and 1.88 (95% CI 1.71-2.06) for association between PPI use and ESRD, respectively. However, there was no association between the use of H2RAs and CKD with a pooled RR of 1.02 (95% CI 0.83-1.25). When compared with the use of H2RAs, the pooled RR of CKD in patients with PPI use was 1.29 (95% CI 1.22-1.36).

CONCLUSIONS

Our study demonstrates statistically significant 1.3-fold increased risks of CKD and ESRD in patients using PPIs, but not in patients using H2RAs.

Authors+Show Affiliations

Department of Internal Medicine, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA.Department of Internal Medicine, Bassett Medical Center, One Atwell Road, Cooperstown, NY, 13326, USA. charat.thongprayoon@gmail.com.Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.Division of Rheumatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.Division of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

28836158

Citation

Wijarnpreecha, Karn, et al. "Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists With Chronic Kidney Disease: a Meta-Analysis." Digestive Diseases and Sciences, vol. 62, no. 10, 2017, pp. 2821-2827.
Wijarnpreecha K, Thongprayoon C, Chesdachai S, et al. Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis. Dig Dis Sci. 2017;62(10):2821-2827.
Wijarnpreecha, K., Thongprayoon, C., Chesdachai, S., Panjawatanana, P., Ungprasert, P., & Cheungpasitporn, W. (2017). Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis. Digestive Diseases and Sciences, 62(10), pp. 2821-2827. doi:10.1007/s10620-017-4725-5.
Wijarnpreecha K, et al. Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists With Chronic Kidney Disease: a Meta-Analysis. Dig Dis Sci. 2017;62(10):2821-2827. PubMed PMID: 28836158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of Proton-Pump Inhibitors and H2 Receptor Antagonists with Chronic Kidney Disease: A Meta-Analysis. AU - Wijarnpreecha,Karn, AU - Thongprayoon,Charat, AU - Chesdachai,Supavit, AU - Panjawatanana,Panadeekarn, AU - Ungprasert,Patompong, AU - Cheungpasitporn,Wisit, Y1 - 2017/08/23/ PY - 2017/06/14/received PY - 2017/08/16/accepted PY - 2017/8/25/pubmed PY - 2017/10/25/medline PY - 2017/8/25/entrez KW - Chronic kidney diseases KW - End-stage kidney disease KW - Meta-analysis KW - Proton-pump inhibitors KW - Renal disease SP - 2821 EP - 2827 JF - Digestive diseases and sciences JO - Dig. Dis. Sci. VL - 62 IS - 10 N2 - BACKGROUND/AIMS: The aim of this meta-analysis was to assess the risks of chronic kidney disease (CKD) and/or end-stage kidney disease (ESRD) in patients who are taking proton-pump inhibitors (PPIs) and/or H2 receptor antagonists (H2RAs). METHODS: Comprehensive literature review was conducted utilizing MEDLINE and EMBASE databases through April 2017 to identify all studies that investigated the risks of CKD or ESRD in patients taking PPIs/H2RAs versus those without PPIs/H2RAs. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42017067252). RESULTS: Five studies with 536,902 participants were patients were identified and included in the data analysis. When compared with non-PPIs users, the pooled risk ratio (RR) of CKD or ESRD in patients with PPI use was 1.33 (95% CI 1.18-1.51). Pre-specified subgroup analysis (stratified by CKD or ESRD status) demonstrated pooled RRs of 1.22 (95% CI 1.14-1.30) for association between PPI use and CKD and 1.88 (95% CI 1.71-2.06) for association between PPI use and ESRD, respectively. However, there was no association between the use of H2RAs and CKD with a pooled RR of 1.02 (95% CI 0.83-1.25). When compared with the use of H2RAs, the pooled RR of CKD in patients with PPI use was 1.29 (95% CI 1.22-1.36). CONCLUSIONS: Our study demonstrates statistically significant 1.3-fold increased risks of CKD and ESRD in patients using PPIs, but not in patients using H2RAs. SN - 1573-2568 UR - https://www.unboundmedicine.com/medline/citation/28836158/Associations_of_Proton_Pump_Inhibitors_and_H2_Receptor_Antagonists_with_Chronic_Kidney_Disease:_A_Meta_Analysis_ L2 - https://doi.org/10.1007/s10620-017-4725-5 DB - PRIME DP - Unbound Medicine ER -