Department of Health Sciences, Federal University of São João Del-Rei (UFSJ), Divinópolis, Minas Gerais, Brazil.
Department of Nephrology, Ambulatory of Municipal Polyclinic of Divinopolis, Divinópolis, Minas Gerais, Brazil.
PLoS One. 2020 Mar 4;15(3):e0229344. doi: 10.1371/journal.pone.0229344. eCollection 2020.
RATIONALE, AIMS AND OBJECTIVES: In recent years, the use of proton pump inhibitors (PPI), especially omeprazole, has been associated with development of chronic kidney disease (CKD). These drugs are widely used worldwide. Although some studies have found an association between the use of PPI and the onset of acute renal failure and CKD. This study aims to analyze the association between the continuous use of omeprazole and the progression of CKD in adult and elderly individuals.
A retrospective cohort study was conducted with patients followed up at a nephrology clinic in Brazil, in 2016 and 2017. Information about clinical and sociodemographic data, health behaviors, and medication use were collected from all patients diagnosed with CKD through consultation of medical charts and the Brazilian health information system (SIS). The participants were allocated into two groups: users and non-users of omeprazole, and the progression of CKD was then evaluated for each group. In the bivariate analysis, the Mann-Whitney U test to compare the quantitative variables between groups, and the Pearson/Fisher two-tailed chi-square test to compare the categorical variables were applied. Multivariate analysis was performed using Cox regression.
A total of 199 CKD patients were attended in the polyclinic, and of these, 42.7% were omeprazole users. There was a higher percentage of CKD progression in users (70.6%) compared to non-users (10.5%). The hazard ratio was 7.34 (CI: 3.94-13.71), indicating a higher risk of progression to worse stages of CKD in omeprazole users than in non-users. As for the other variables, no statistically significant difference was found between groups (p > 0.05).
An association between omeprazole use and progression of CKD stage was identified, showing a higher risk of disease evolution among omeprazole users.
背景、目的和目标：近年来，质子泵抑制剂（PPI）的使用，特别是奥美拉唑的使用，与慢性肾脏病（CKD）的发生有关。这些药物在全球范围内广泛使用。尽管一些研究发现 PPI 的使用与急性肾衰竭和 CKD 的发生之间存在关联。本研究旨在分析奥美拉唑的连续使用与成人和老年人 CKD 进展之间的关系。
这是一项回顾性队列研究，对巴西一家肾病诊所的患者进行了随访，时间为 2016 年和 2017 年。通过查阅病历和巴西健康信息系统（SIS），收集所有被诊断为 CKD 的患者的临床和社会人口统计学数据、健康行为和药物使用信息。将参与者分为奥美拉唑使用者和非使用者两组，然后评估每组 CKD 的进展情况。在双变量分析中，应用 Mann-Whitney U 检验比较组间的定量变量，应用 Pearson/Fisher 双侧卡方检验比较分类变量。采用 Cox 回归进行多变量分析。
该门诊共收治了 199 例 CKD 患者，其中 42.7%为奥美拉唑使用者。使用者（70.6%）的 CKD 进展比例高于非使用者（10.5%）。风险比为 7.34（95%CI：3.94-13.71），表明与非使用者相比，奥美拉唑使用者 CKD 进展至更差阶段的风险更高。对于其他变量，组间无统计学差异（p>0.05）。
发现奥美拉唑使用与 CKD 分期进展之间存在关联，表明奥美拉唑使用者疾病进展的风险更高。
