Wakabayashi Tomohito, Hosohata Keiko, Oyama Saki, Inada Ayaka, Niinomi Iku, Kambara Hiroko, Iida Tatsuya, Hasebe Keiko, Matsuoka Hiroyuki, Uchida Mayako, Kumagai Etsuko
Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences, Osaka, Japan.
Department of Nephrology, Kenwakai Hospital, Nagano, Japan.
J Int Med Res. 2021 Apr;49(4):3000605211006653. doi: 10.1177/03000605211006653.
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.
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.
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.
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.
质子泵抑制剂（PPIs）被广泛用于抑酸治疗。最近，有报道称使用PPIs与慢性肾脏病（CKD）有关；然而，低剂量PPIs是否与CKD有关仍不清楚。
这项回顾性观察研究纳入了2017年至2019年间到Kenwakai医院就诊的高血压患者。从病历中提取估算肾小球滤过率（eGFR）和血清肌酐（Scr）等肾脏参数，并在治疗前三年与基线进行比较。PPI的使用评估为三年的累积暴露量。
研究人群包括152名患者（男性占57.9%；平均年龄74.5岁）。其中，35.5%为PPI使用者（低剂量使用者占17.1%；高剂量使用者占18.4%）。在高剂量PPI组中，观察到治疗前三年与基线之间eGFR显著下降和Scr升高，而在未使用或低剂量PPI组中未观察到。
我们的结果表明，低剂量PPIs在临床环境中可能是安全的，但需要进一步的前瞻性研究来阐明我们的发现。
