Association between a low dose of proton pump inhibitors and kidney function decline in elderly hypertensive patients: a retrospective observational study

Objectives Proton pump inhibitors (PPIs) are widely used for acid suppression therapy. Recently, PPI use was reported to be associated with chronic kidney disease (CKD); however, whether a low dose of PPIs is associated with CKD remains unknown. Methods This retrospective observational study included hypertensive patients who visited Kenwakai Hospital between 2017 and 2019. Renal parameters, such as the estimated glomerular filtration rate (eGFR) and serum creatinine (Scr), were extracted from medical records and compared between three years before treatment and the baseline. PPI use was assessed as cumulative exposure for three years. Results The study population included 152 patients (57.9% men; mean age, 74.5 years). Of those, 35.5% were PPI users (low dose, 17.1%; high dose, 18.4%). A significant decrease in eGFR and an increase in Scr were observed between three years before treatment and the baseline in the high-dose PPI group but not the non-use or low-dose PPI groups. Conclusions Our results suggest that a low dose of PPIs may be safe in clinical settings, but further prospective studies are needed to clarify our findings.

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Effect of Proton Pump Inhibitors on Risks of Upper and Lower Gastrointestinal Bleeding among Users of Low-Dose Aspirin: A Population-Based Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm9040928 ◽

2020 ◽

Vol 9 (4) ◽

pp. 928

Author(s):

Luis A. García Rodríguez ◽

Angel Lanas ◽

Montse Soriano-Gabarró ◽

Pareen Vora ◽

Lucía Cea Soriano

Keyword(s):

Observational Study ◽

Gastrointestinal Bleeding ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Low Dose ◽

Population Based ◽

Lower Gastrointestinal Bleeding ◽

Aspirin Therapy ◽

Dose Aspirin ◽

Low Dose Aspirin

Estimates of the effect of proton pump inhibitors (PPIs) on risks of upper and lower gastrointestinal bleeding (UGIB and LGIB) among low-dose aspirin users in routine clinical practice are variable (UGIB) or lacking (LGIB). We aimed to establish these risks in the same observational study population. Using UK primary care data, we followed 199,049 new users of low-dose aspirin (75–300 mg/day) and matched non-users at start of follow-up to identify incident UGIB/LGIB cases. In nested case–control analyses, adjusted odds ratios (ORs) were calculated for concomitant PPI use vs. past (discontinued) PPI use among current low-dose aspirin users. For UGIB (n = 987), ORs (95% CIs) were 0.69 (0.54–0.88) for >1 month PPI use and 2.65 (1.62–4.3) for ≤1 month PPI use. Among the latter group, ORs (95% CIs) were 3.05 (1.75–5.33) for PPI initiation after start of aspirin therapy, and 1.66 (0.63–4.36) for PPI initiation on/before start of aspirin therapy. For LGIB (n = 1428), ORs (95% CIs) were 0.98 (0.81–1.17) for >1 month PPI use and 1.12 (0.73–1.71) for ≤1 month PPI use. Among low-dose aspirin users, maintaining PPI use (>1 month) was associated with a significantly reduced UGIB risk. Neither short nor long-term PPI use affected LGIB risk.

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Acid Suppression Use Among Infants in One Tertiary Children's Hospital in China, 2015–2018: A Retrospective Observational Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.679203 ◽

2021 ◽

Vol 9 ◽

Author(s):

Yue Zhou ◽

Lina Xu ◽

Haishaerjiang Wushouer ◽

Aichen Yu ◽

Ziyue Xu ◽

...

Keyword(s):

Observational Study ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Clinical Guidelines ◽

Digestive System ◽

Acid Suppression ◽

Retrospective Observational Study ◽

Children's Hospital ◽

Children’S Hospital ◽

Digestive System Diseases

Clinical guidelines emphasized that physicians should be cautious when prescribing acid suppressions to infants. Histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are not approved for use in infants aged below 2 years in China. We investigated H2RA/PPI use in infants aged below 2 years hospitalized between 1st January 2015 and 31st December 2018 in a Chinese tertiary children's hospital. Our study observed that H2RAs/PPIs were frequently prescribed with a prevalence of 4.4% (7,158/162,192). The frequency of PPI use was over two-fold than that of H2RA use (71.9%, 5,148/7,158; 28.1%, 2,011/7,158). H2RAs/PPIs were commonly used to treat infants without digestive system diseases (57.5%, 4,118/7,158). Further studies are urgently needed to evaluate the effectiveness and safety of H2RAs/PPIs in infants.

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High-dose vs. Low-dose Proton Pump Inhibitors post-endoscopic hemostasis in patients with bleeding peptic ulcer. A meta-analysis and meta-regression analysis

The Turkish Journal of Gastroenterology ◽

10.5152/tjg.2018.17143 ◽

2018 ◽

Vol 29 (1) ◽

pp. 22-31 ◽

Cited By ~ 1

Author(s):

George Sgourakis ◽

George Chatzidakis ◽

Androniki Poulou ◽

Panagiota Malliou ◽

Theodoros Argyropoulos ◽

...

Keyword(s):

Regression Analysis ◽

Peptic Ulcer ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Low Dose ◽

Meta Analysis ◽

Bleeding Peptic Ulcer ◽

High Dose ◽

Meta Regression ◽

Meta Regression Analysis

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Different dose of new generation proton pump inhibitors for the treatment of Helicobacter pylori infection: A meta-analysis

International Journal of Immunopathology and Pharmacology ◽

10.1177/20587384211030397 ◽

2021 ◽

Vol 35 ◽

pp. 205873842110303

Author(s):

Wenwen Gao ◽

Xiang Zhang ◽

Yanhui Yin ◽

Shuwen Yu ◽

Lu Wang

Keyword(s):

Helicobacter Pylori ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Eradication Rate ◽

Standard Dose ◽

Statistical Significance ◽

High Dose ◽

Clarithromycin Resistance ◽

H Pylori ◽

New Generation

The evidence on whether high-dose new generation proton pump inhibitors (PPIs) including rabeprazole and esomeprazole achieve a higher eradication rate of Helicobacter pylori has not been assessed. The primary comparison was eradication and adverse events (AEs) rate of standard (esomeprazole 20 mg bid, rabeprazole 10 mg bid) versus high-dose (esomeprazole 40 mg bid, rabeprazole 20 mg bid) PPIs. Sub-analyses were performed to evaluate the eradication rate between Asians and Caucasians, clarithromycin-resistance (CAM-R) strains, and clarithromycin-sensitivity (CAM-S) strains of different dose PPIs. We conducted a literature search for randomized controlled trials comparing high-with standard-dose esomeprazole and rabeprazole for H. pylori eradication and AEs. A total of 12 trials with 2237 patients were included. The eradication rate of high-dose PPIs was not significantly superior to standard-dose PPIs regimens: 85.3% versus 84.2%, OR 1.09 (0.86–1.37), P = 0.47. The high dose induced more AEs than those of the standard dose, but didn’t reach statistical significance (OR 1.25, 95% CI: 0.99–1.56, P = 0.06). Subgroup analysis showed that the difference in eradication rate of PPIs between high- and standard-dose groups were not statistically significant both in Asians (OR 0.99, 95% CI 0.75–1.32, P = 0.97) and Caucasians (OR 1.27, 95% CI 0.84–1.92, P = 0.26). Furthermore, there were similar eradication rates in CAM-S (OR 1.2; 95% CI 0.58–2.5; P = 0.63) and CAM-R strains (OR 1.08; 95% CI 0.45–2.56; P = 0.87) between the standard-and high-dose groups. High and standard dosages of new generation of the PPIs showed similar H. pylori eradication rates and AEs as well as between Asian versus Caucasian populations, with or without clarithromycin-resistance. However, further studies are needed to confirm.

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