Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank
Background: Proton pump inhibitors (PPIs) are widely used and have been linked to kidney diseases. However, the role of PPI use in the development of chronic kidney disease (CKD) remains unclear. We undertook this study to examine the association between PPI use and the subsequent risk of CKD.Method...
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| Format: | Article |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.949699/full |
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| author | Xing-Yu Zhang Qiang-Sheng He Zhong Jing Juan-Xia He Jin-Qiu Yuan Xiao-Yu Dai |
| author_facet | Xing-Yu Zhang Qiang-Sheng He Zhong Jing Juan-Xia He Jin-Qiu Yuan Xiao-Yu Dai |
| author_sort | Xing-Yu Zhang |
| collection | DOAJ |
| description | Background: Proton pump inhibitors (PPIs) are widely used and have been linked to kidney diseases. However, the role of PPI use in the development of chronic kidney disease (CKD) remains unclear. We undertook this study to examine the association between PPI use and the subsequent risk of CKD.Methods: This is a prospective analysis of 462,421 participants free of cancer diagnosis or chronic kidney disease from the United Kingdom Biobank. Self-reported PPI use was recorded using an electronic questionnaire and confirmed by a trained staff. Incident CKD was identified based on the medical history. Overlap propensity score weighting with the Cox model was used to calculate the effect of PPI use on CKD risk. The number needed to harm (NNH) was calculated at 5 and 10 years of follow-up.Results: We documented 7,031 cases of CKD over a median follow-up of 8.1 years. Overlap propensity score weighting analysis showed that regular PPI users had a 37% higher risk of CKD incident than non-users (HR 1.37, 95% CI 1.28–1.47). The association persisted across subgroup analyses, different types of PPIs, and several sensitivity analyses. Quantitative bias analysis indicated that the result was robust to unmeasured confounding (E-value 2.08, lower 95% CI 1.88). The NNH was 147.9 and 78.6 for 5 and 10 years of follow-up, respectively. A head-to-head comparison showed that PPI users had a 19% higher risk of CKD than H2RA users (HR 1.19, 95% CI 1.02–1.39).Conclusion: The regular use of PPI is associated with a higher risk of CKD. Healthcare providers should carefully weigh up the potential benefits against the risk in prescribing PPIs, particularly for patients requiring long-term treatment. |
| first_indexed | 2024-04-11T08:11:33Z |
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| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-11T08:11:33Z |
| publishDate | 2022-11-01 |
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| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-6d18969d6bc745ed9154c4d9fd7f6ea12022-12-22T04:35:21ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-11-011310.3389/fphar.2022.949699949699Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom BiobankXing-Yu Zhang0Qiang-Sheng He1Zhong Jing2Juan-Xia He3Jin-Qiu Yuan4Xiao-Yu Dai5Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, ChinaClinical Research Center, Guangdong; Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, ChinaDepartment of Nephrology, Mianyang 404 Hospital, Mianyang, ChinaDepartment of Information Engineering, University of Lanzhou City, Lanzhou, ChinaClinical Research Center, Guangdong; Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, ChinaDepartment of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, ChinaBackground: Proton pump inhibitors (PPIs) are widely used and have been linked to kidney diseases. However, the role of PPI use in the development of chronic kidney disease (CKD) remains unclear. We undertook this study to examine the association between PPI use and the subsequent risk of CKD.Methods: This is a prospective analysis of 462,421 participants free of cancer diagnosis or chronic kidney disease from the United Kingdom Biobank. Self-reported PPI use was recorded using an electronic questionnaire and confirmed by a trained staff. Incident CKD was identified based on the medical history. Overlap propensity score weighting with the Cox model was used to calculate the effect of PPI use on CKD risk. The number needed to harm (NNH) was calculated at 5 and 10 years of follow-up.Results: We documented 7,031 cases of CKD over a median follow-up of 8.1 years. Overlap propensity score weighting analysis showed that regular PPI users had a 37% higher risk of CKD incident than non-users (HR 1.37, 95% CI 1.28–1.47). The association persisted across subgroup analyses, different types of PPIs, and several sensitivity analyses. Quantitative bias analysis indicated that the result was robust to unmeasured confounding (E-value 2.08, lower 95% CI 1.88). The NNH was 147.9 and 78.6 for 5 and 10 years of follow-up, respectively. A head-to-head comparison showed that PPI users had a 19% higher risk of CKD than H2RA users (HR 1.19, 95% CI 1.02–1.39).Conclusion: The regular use of PPI is associated with a higher risk of CKD. Healthcare providers should carefully weigh up the potential benefits against the risk in prescribing PPIs, particularly for patients requiring long-term treatment.https://www.frontiersin.org/articles/10.3389/fphar.2022.949699/fullproton pump inhibitorschronic kidney diseaseUnited Kingdom Biobankcohortpropensity score weighting via overlap weights |
| spellingShingle | Xing-Yu Zhang Qiang-Sheng He Zhong Jing Juan-Xia He Jin-Qiu Yuan Xiao-Yu Dai Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank Frontiers in Pharmacology proton pump inhibitors chronic kidney disease United Kingdom Biobank cohort propensity score weighting via overlap weights |
| title | Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank |
| title_full | Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank |
| title_fullStr | Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank |
| title_full_unstemmed | Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank |
| title_short | Effect of proton pump inhibitors on the risk of chronic kidney disease: A propensity score-based overlap weight analysis using the United Kingdom Biobank |
| title_sort | effect of proton pump inhibitors on the risk of chronic kidney disease a propensity score based overlap weight analysis using the united kingdom biobank |
| topic | proton pump inhibitors chronic kidney disease United Kingdom Biobank cohort propensity score weighting via overlap weights |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.949699/full |
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