PMID- 27492273
OWN - NLM
STAT- MEDLINE
DCOM- 20170814
LR  - 20201209
IS  - 1552-4604 (Electronic)
IS  - 0091-2700 (Print)
IS  - 0091-2700 (Linking)
VI  - 56
IP  - 12
DP  - 2016 Dec
TI  - Proton Pump Inhibitors Are Not Associated With Acute Kidney Injury in Critical 
      Illness.
PG  - 1500-1506
LID - 10.1002/jcph.805 [doi]
AB  - Recent epidemiologic data linking proton pump inhibitor (PPI) use to acute and 
      chronic kidney dysfunction is yet to be validated in other populations, and 
      mechanisms have not been explored. Using a large, well phenotyped inception 
      cohort of 15 063 critically ill patients, we examined the risk of acute kidney 
      injury (AKI), as defined by the Kidney Disease Improving Global Outcomes criteria 
      guidelines, according to prior use of a PPI, histamine-2 receptor antagonist 
      (H(2) RA), or neither. A total of 3725 (24.7%) patients reported PPI use prior to 
      admission, while 905 (6.0%) patients reported H(2) RA use. AKI occurred in 747 
      (20.0%) and 163 (18.0%) of PPI and H(2) RA users respectively, compared to 1712 
      (16.2%) of those not taking acid suppressive medications. In unadjusted analysis, 
      PPI and H(2) RA users had a 28% (95%CI 1.17-1.41, P < .001) and 10% (95%CI 
      0.91-1.30, P = .31) higher risk of AKI compared to those taking neither class of 
      medication. However, in sequential models that included adjustment for 
      demographics, cardiovascular comorbidities, indications for PPI use, and severity 
      of illness, the effect of PPI on the risk of AKI was attenuated, and in the 
      adjusted analysis, PPI was not associated with AKI (OR 1.02; 95%CI 0.91-1.13, P = 
      .73). The presence of sterile pyuria and hypomagnesemia did not modify the 
      association between PPI use and AKI. In summary, after adjustment for 
      demographics, illness severity, and the indication for PPI use, PPI use prior to 
      admission is not associated with critical illness AKI.
CI  - (c) 2016, The American College of Clinical Pharmacology.
FAU - Lee, Joon
AU  - Lee J
AD  - Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA.
AD  - School of Public Health and Health Systems, University of Waterloo, Waterloo, 
      Ontario, Canada.
FAU - Mark, Roger G
AU  - Mark RG
AD  - Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA.
FAU - Celi, Leo Anthony
AU  - Celi LA
AD  - Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA.
AD  - Beth Israel Deaconess Medical Center, Department of Medicine, Boston, MA, USA.
FAU - Danziger, John
AU  - Danziger J
AD  - Beth Israel Deaconess Medical Center, Department of Medicine, Boston, MA, USA.
LA  - eng
GR  - R01 EB001659/EB/NIBIB NIH HHS/United States
GR  - R01 EB017205/EB/NIBIB NIH HHS/United States
GR  - R01 GM104987/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20160912
PL  - England
TA  - J Clin Pharmacol
JT  - Journal of clinical pharmacology
JID - 0366372
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Acute Kidney Injury/*diagnosis/epidemiology
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Critical Illness/epidemiology/*therapy
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/adverse effects/*therapeutic use
PMC - PMC5154974
MID - NIHMS808576
OTO - NOTNLM
OT  - acute kidney injury
OT  - histamine receptor antagonist blocker
OT  - proton pump inhibitor
COIS- The contributing authors declare that there was no conflict of interest.
EDAT- 2016/08/06 06:00
MHDA- 2017/08/15 06:00
PMCR- 2017/12/01
CRDT- 2016/08/06 06:00
PHST- 2016/06/30 00:00 [received]
PHST- 2016/08/02 00:00 [revised]
PHST- 2016/08/03 00:00 [accepted]
PHST- 2016/08/06 06:00 [pubmed]
PHST- 2017/08/15 06:00 [medline]
PHST- 2016/08/06 06:00 [entrez]
PHST- 2017/12/01 00:00 [pmc-release]
AID - 10.1002/jcph.805 [doi]
PST - ppublish
SO  - J Clin Pharmacol. 2016 Dec;56(12):1500-1506. doi: 10.1002/jcph.805. Epub 2016 Sep 
      12.