Changes in estimated glomerular filtration rate in patients administered proton pump inhibitors: a single-center cohort study

• Published in: Naunyn-Schmiedeberg's archives of pharmacology 2024-07, Vol.397 (7), p.4927-4938
• Main Authors: Murofushi, Takuma, Yagi, Tatsuya, Tsuji, Daiki, Furushima, Daisuke, Fujikura, Tomoyuki, Itoh, Kunihiko, Kawakami, Junichi
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Aged, 80 and over; Biomedical and Life Sciences; Biomedicine; Cohort analysis; Cohort Studies; Drug abuse; Epidermal growth factor receptors; Female; Glomerular filtration rate; Glomerular Filtration Rate - drug effects; Histamine H2 Antagonists - administration & dosage; Histamine H2 receptors; Humans; Japan; Male; Middle Aged; Neurosciences; Pharmacology/Toxicology; Proton pump inhibitors; Proton Pump Inhibitors - administration & dosage; Proton Pump Inhibitors - adverse effects; Renal function
• ISSN: 0028-1298; 1432-1912; 1432-1912
• DOI: 10.1007/s00210-023-02890-y

Proton pump inhibitor (PPI) use may be associated with renal dysfunction. Renal dysfunction in PPI users requires evaluation of development and progression risks simultaneously, using estimated glomerular filtration rate (eGFR) slope, which indicates changes in eGFR per year. To the best of our knowledge, no studies have evaluated eGFR slope in PPI users. This study investigated the association between PPI use and renal dysfunction using eGFR slope. A single-center cohort study was conducted using the health records data at Hamamatsu University Hospital in Japan. Participants were defined as first users of acid-suppressing drugs (PPIs or Histamine H 2 receptor antagonists (H 2 RAs)) from 2010 to 2021 and continuously prescribed for  ≥ 90 days. The H 2 RA group was used for the propensity-score matching (PSM) to the PPI group to minimize the effects of confounders. The eGFR slope was estimated using a linear mixed effects model. Participants were stratified by baseline eGFR and age, respectively, as subgroup analyses. A total of 4,649 acid-suppressing drug users met the inclusion criteria, including 950 taking H 2 RAs and 3,699 PPIs. After PSM, 911 patients were assigned to each group. The eGFR slopes of the PPI and H 2 RA users were -4.75 (95% CI: -6.29, -3.20) and -3.40 (-4.38, -2.42), respectively. The difference between the groups was not significant. Significant declines in eGFR were observed with PPIs with baseline eGFR ≥ 90 and age