Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
Data to draw definite conclusions regarding the association between proton pump inhibitor (PPI) and all-cause mortality in patients undergoing hemodialysis (HD) remain insufficient. The object of this retrospective study was to assess the impact of PPIs on patient survival within a substantial cohor...
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/14/4749 |
| _version_ | 1797588867202678784 |
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| author | Seok Hui Kang Gui Ok Kim Bo Yeon Kim Eun Jung Son Jun Young Do |
| author_facet | Seok Hui Kang Gui Ok Kim Bo Yeon Kim Eun Jung Son Jun Young Do |
| author_sort | Seok Hui Kang |
| collection | DOAJ |
| description | Data to draw definite conclusions regarding the association between proton pump inhibitor (PPI) and all-cause mortality in patients undergoing hemodialysis (HD) remain insufficient. The object of this retrospective study was to assess the impact of PPIs on patient survival within a substantial cohort of individuals receiving maintenance HD. To achieve this, the study employed laboratory and clinical data sourced from the 4th, 5th, and 6th National HD Quality Assessment Programs. The programs included patients undergoing maintenance HD (n = 54,903). Based on the PPI prescription data collected over the 6-month HD quality assessment, the patients were categorized into three groups: Group 1, comprising individuals with not prescription; Group 2, consisting of patients prescribed PPIs for less than 90 days; and Group 3, comprising patients prescribed PPIs for 90 days or more. The respective number of patients in Groups 1, 2, and 3 was 43,059 (78.4%), 5065 (9.2%), and 6779 (12.3%), respectively. Among the study groups, the 5-year survival rates were as follows: Group 1—70.0%, Group 2—68.4%, and Group 3—63.0%. The hazard ratio for Group 3 was 1.09 (95% CI, 1.04 to 1.15; <i>p</i> < 0.001) and 1.10 (95% CI, 1.03 to 1.18; <i>p</i> = 0.007) compared to Groups 1 or 2 based on multivariable analysis. Multivariable analyses revealed a lower rate of patient survival in Group 3 compared to the other groups, while Groups 1 and 2 exhibited similar patient survival rates. Our study revealed a significant association between long-term PPI usage and increased mortality among patients undergoing HD. However, distinct trends were observed in subgroup analyses. The association between long-term PPI usage and mortality was prominent in patients who did not have a high gastrointestinal burden or comorbidities. Meanwhile, this association was not observed in patients who did have a high gastrointestinal burden or comorbidities. |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T00:58:07Z |
| publishDate | 2023-07-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d934f84e38bc4a4ea22439c799cf02ef2023-11-18T19:53:24ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011214474910.3390/jcm12144749Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance HemodialysisSeok Hui Kang0Gui Ok Kim1Bo Yeon Kim2Eun Jung Son3Jun Young Do4Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of KoreaHealthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju 26465, Republic of KoreaHealthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju 26465, Republic of KoreaHealthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju 26465, Republic of KoreaDivision of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of KoreaData to draw definite conclusions regarding the association between proton pump inhibitor (PPI) and all-cause mortality in patients undergoing hemodialysis (HD) remain insufficient. The object of this retrospective study was to assess the impact of PPIs on patient survival within a substantial cohort of individuals receiving maintenance HD. To achieve this, the study employed laboratory and clinical data sourced from the 4th, 5th, and 6th National HD Quality Assessment Programs. The programs included patients undergoing maintenance HD (n = 54,903). Based on the PPI prescription data collected over the 6-month HD quality assessment, the patients were categorized into three groups: Group 1, comprising individuals with not prescription; Group 2, consisting of patients prescribed PPIs for less than 90 days; and Group 3, comprising patients prescribed PPIs for 90 days or more. The respective number of patients in Groups 1, 2, and 3 was 43,059 (78.4%), 5065 (9.2%), and 6779 (12.3%), respectively. Among the study groups, the 5-year survival rates were as follows: Group 1—70.0%, Group 2—68.4%, and Group 3—63.0%. The hazard ratio for Group 3 was 1.09 (95% CI, 1.04 to 1.15; <i>p</i> < 0.001) and 1.10 (95% CI, 1.03 to 1.18; <i>p</i> = 0.007) compared to Groups 1 or 2 based on multivariable analysis. Multivariable analyses revealed a lower rate of patient survival in Group 3 compared to the other groups, while Groups 1 and 2 exhibited similar patient survival rates. Our study revealed a significant association between long-term PPI usage and increased mortality among patients undergoing HD. However, distinct trends were observed in subgroup analyses. The association between long-term PPI usage and mortality was prominent in patients who did not have a high gastrointestinal burden or comorbidities. Meanwhile, this association was not observed in patients who did have a high gastrointestinal burden or comorbidities.https://www.mdpi.com/2077-0383/12/14/4749dialysishemodialysismortalityproton pump inhibitor |
| spellingShingle | Seok Hui Kang Gui Ok Kim Bo Yeon Kim Eun Jung Son Jun Young Do Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis Journal of Clinical Medicine dialysis hemodialysis mortality proton pump inhibitor |
| title | Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis |
| title_full | Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis |
| title_fullStr | Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis |
| title_full_unstemmed | Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis |
| title_short | Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis |
| title_sort | effects of proton pump inhibitors on patient survival in patients undergoing maintenance hemodialysis |
| topic | dialysis hemodialysis mortality proton pump inhibitor |
| url | https://www.mdpi.com/2077-0383/12/14/4749 |
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