Article Figures & Tables
Figures
- Figure 1:
Kaplan–Meier curves for admission to hospital with acute kidney injury, by group.
Tables
- Table 1: Baseline characteristics of 290 592 patients newly prescribed proton pump inhibitor therapy and an equal number of matched controls
Variable Group; no. (%)* of patients PPI Control Standardized difference Age, median (IQR), yr 74 (69–80) 74 (69–80) 0.00 66–74 152 738 (52.6) 152 485 (52.5) 0.00 75–84 103 550 (35.6) 103 628 (35.7) 0.00 ≥ 85 34 304 (11.8) 34 479 (11.9) 0.00 Female sex 164 724 (56.7) 164 724 (56.7) 0.00 Charlson Comorbidity Index score No hospital admission 104 653 (36.0) 96 921 (33.4) 0.06 0 119 351 (41.1) 128 762 (44.3) 0.07 1 27 954 (9.6) 27 740 (9.5) 0.00 ≥ 2 38 634 (13.3) 37 169 (12.8) 0.02 No. of hospital admissions in previous yr 0 (0–0) 0 (0–0) 0.02 Residence in a long-term care facility 13 161 (4.5) 11 889 (4.1) 0.02 No. of prescription drugs in previous yr, median (IQR) 6 (3–9) 6 (3–9) 0.01 Medication use in previous 120 d Oral corticosteroids 6 351 (2.2) 5 501 (1.9) 0.02 Anticoagulants 16 990 (5.8) 16 662 (5.7) 0.01 Calcium channel blockers 68 078 (23.4) 69 181 (23.8) 0.01 Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker 110 527 (38.0) 114 843 (39.5) 0.03 Potassium-sparing diuretics 4 145 (1.4) 3 969 (1.4) 0.00 Fibric acid derivatives 5 268 (1.8) 5 522 (1.9) 0.01 Metformin 31 198 (10.7) 32 673 (11.2) 0.02 Sulfonylureas 18 753 (6.5) 19 425 (6.7) 0.01 Insulin 7 093 (2.4) 7 132 (2.5) 0.00 Thiazolidinediones 3 290 (1.1) 3 585 (1.2) 0.01 Other oral antihypoglycemics 1 546 (0.5) 1 500 (0.5) 0.00 Chronic NSAIDs 43 719 (15.0) 41 821 (14.4) 0.02 Chronic diuretics 96 659 (33.3) 99 948 (34.4) 0.02 β-adrenergic antagonists 65 227 (22.4) 66 329 (22.8) 0.01 Income quintile 1 (lowest) 56 902 (19.6) 55 615 (19.1) 0.01 2 61 151 (21.0) 60 994 (21.0) 0.00 3 57 491 (19.8) 57 942 (19.9) 0.00 4 56 741 (19.5) 57 689 (19.9) 0.01 5 (highest) 57 105 (19.7) 57 463 (19.8) 0.00 Medical conditions and procedures in previous 5 yr Gastrointestinal hemorrhage 1 610 (0.6) 1 366 (0.5) 0.01 Peptic ulcer disease 25 113 (8.6) 22 756 (7.8) 0.03 Esophageal disease 14 557 (5.0) 11 620 (4.0) 0.05 Diabetes 68 921 (23.7) 69 681 (24.0) 0.01 Hypertension 200 516 (69.0) 205 589 (70.7) 0.04 Chronic alcohol use 7 321 (2.5) 7 371 (2.5) 0.00 Systemic malignancy 13 676 (4.7) 13 486 (4.6) 0.00 Chronic kidney disease 12 018 (4.1) 12 018 (4.1) 0.00 Chronic liver disease 1 679 (0.6) 1 654 (0.6) 0.00 Congestive heart failure 25 184 (8.7) 22 963 (7.9) 0.03 Note: IQR = interquartile range, NSAID = nonsteroidal anti-inflammatory drug, PPI = proton pump inhibitor. *Unless stated otherwise.
- Table 2: Association between proton pump inhibitor use and kidney outcomes in 290 592 patients newly prescribed proton pump inhibitor therapy and an equal number of matched controls
Variable Group; no. (%) of events Group; rate per 1000 person-years HR (95% CI)* PPI Control PPI Control Kidney outcomes Acute kidney injury 1 269 (0.4) 518 (0.2) 13.49 5.46 2.52 (2.27 to 2.79) Acute interstitial nephritis 30 (0.0) 10 (0.0) 0.32 0.11 3.00 (1.47 to 6.14) Tracer outcome Cataract surgery 4 976 (1.7) 5 179 (1.8) 53.30 55.12 0.97 (0.93 to 1.00) Note: CI = confidence interval, HR = hazard ratio, PPI = proton pump inhibitor. *Reference group is patients not prescribed a PPI.
Group; rate per 1000 person-years PPI Control PPI No. patients per group HR (95% CI)* Lansoprazole 27 340 14.61 5.83 2.56 (1.85 to 3.55) Omeprazole 45 020 12.77 4.56 2.94 (2.21 to 3.91) Pantoprazole 57 381 16.39 6.89 2.43 (1.97 to 3.00) Rabeprazole 160 851 12.48 5.14 2.45 (2.12 to 2.83) Note: CI = confidence interval, HR = hazard ratio, PPI = proton pump inhibitor.
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