The following article features coverage from Kidney Week 2019. Click here to read more of Renal & Urology News’ conference coverage.

WASHINGTON—Chronic use of proton pump inhibitors (PPIs) may accelerate progression of chronic kidney disease (CKD), according to new study findings presented at the American Society of Nephrology’s 2019 Kidney Week conference.

PPIs are acid-activated prodrugs that inhibit hydrogen-potassium ATPase in the stomach as well in other organs, such as the kidneys.

“There has been concern that PPIs can have effects beyond the gastroesophageal mucosa and may adversely affect the course of CKD. Our data suggest that chronic PPI use leads to metabolic acidosis and accelerates progression of kidney disease in CKD patients,” lead investigator Sixto G. Giusti, MD, of Tulane University School of Medicine in New Orleans, told Renal & Urology News. “Chronic PPI use should be discouraged in this population.”

Using the VA Informatics and Computing Infrastructure national database system, investigators identified patients with stage 3 to 4 CKD and propensity-score matched 1406 patients (mean age 62 years; 62% white; 2% female) who used PPIs for at least a year to 1425 patients (mean age 65 years; 71% white; 1% female) who did not use PPIs. Similar proportions of each group had hypertension and diabetes.

PPI users had a significant 83% increased risk for a 10-unit decline in estimated glomerular filtration rate (eGFR) from baseline, a significant 84% increased risk for dialysis initiation, and a significant 34% increased risk for all-cause mortality, compared with nonusers, Dr Giusti and colleagues reported. The PPI group also had a nonsignificant 34% increased risk for metabolic acidosis.

Read more of Renal & Urology News’ coverage of Kidney Week 2019 by visiting the conference page.

Reference

Giusti SG, Lin Y, Liu S, Nakhoul NL, et al. The effect of proton pump inhibitor use on the development of metabolic acidosis and decline in kidney function in patients with CKD stages G3a to G4. Presented at the American Society of Nephrology’s Kidney Week 2019 conference held November 5-10 in Washington DC. Poster TH-PO452.