Proton Pump Inhibitor Usage and the Risk of Mortality in Hemodialysis Patients

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• dc.contributor.author de Francisco, Angel Luis M.ca
• dc.contributor.author Varas, Javierca
• dc.contributor.author Ramos, Rosaca
• dc.contributor.author Merello, Ignacioca
• dc.contributor.author Canaud, Bernardca
• dc.contributor.author Stuard, Stefanoca
• dc.contributor.author Pascual Santos, Julioca
• dc.contributor.author Aljama, Pedroca
• dc.contributor.author Optimizing Results in Dialysis (ORD) groupca
• dc.date.accessioned 2018-06-21T08:13:16Z
• dc.date.available 2018-06-21T08:13:16Z
• dc.date.issued 2017
• dc.description.abstract INTRODUCTION: Long-term inappropriate proton pump inhibitors use (PPIs) is a matter of concern because of the risks associated with their long-term use in older patients with chronic conditions. The risk of PPI treatment in hemodialysis patients remains unexplored. METHODS: We assessed the relationship between the use of PPIs and the risk of death in hemodialysis patients throughout a retrospective multicenter propensity score-matched study. Information about demographic, hemodialysis treatment, laboratory data, and concomitant medication was obtained from the EuCliD database (Fresenius Medical Care). We studied 1776 hemodialysis patients on PPI therapy compared to 466 patients not receiving PPIs. The resulting population comprising 2 groups of 410 matched patients was studied. RESULTS: PPI use was associated with hypomagnesemia (Mg <1.8 mg/dl (0.75 mmol/l); odds ratio [OR] = 2.70, 95% confidence interval [CI] = 1.38-5.27, P < 0.01). The exposure to PPIs in the full patient cohort was identified as an independent predictor for all-cause mortality in both univariate (HR = 3.16, 95% CI = 1.69-5.90, P < 0.01) and multivariate (HR = 2.70, 95% CI = 1.38-5.27, P < 0.01) Cox regression models. Moreover PPI use was identified as a predictor of CV mortality (HR = 1.51, 95% CI = 1.05-2.20, P = 0.03) Of the 820 patients matched throughout the propensity score analysis, the hazard ratios for all-cause mortality (HR = 1.412, 95% CI = 1.04-1.93, P = 0.03) and CV mortality (HR = 1.67, 95% CI = 1.03-2.71, P = 0.04) were higher among patients on PPIs versus those not on PPIs. CONCLUSION: The study data suggest that the PPI treatment should be regularly monitored and prescribed only when indicated.
• dc.format.mimetype application/pdf
• dc.identifier.citation de Francisco ALM, Varas J, Ramos R, Merello JI, Canaud B, Stuard S. et al. Proton Pump Inhibitor Usage and the Risk of Mortality in Hemodialysis Patients. Kidney Int Rep. 2017 Nov 10;3(2):374-384. DOI: 10.1016/j.ekir.2017.11.001
• dc.identifier.doi http://dx.doi.org/10.1016/j.ekir.2017.11.001
• dc.identifier.issn 2468-0249
• dc.identifier.uri http://hdl.handle.net/10230/34945
• dc.language.iso eng
• dc.publisher Elsevierca
• dc.relation.ispartof Kidney International Reports. 2017 Nov 10;3(2):374-84
• dc.rights Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0
• dc.subject.keyword Hemodialysis
• dc.subject.keyword Magnesium
• dc.subject.keyword Mortality risk
• dc.subject.keyword Proton pump inhibitors
• dc.subject.other Hemodiàlisi
• dc.subject.other Mortalitat
• dc.title Proton Pump Inhibitor Usage and the Risk of Mortality in Hemodialysis Patientsca
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion