Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2017 Apr 24:11:1291-1299.
doi: 10.2147/DDDT.S130568. eCollection 2017.

Proton-pump inhibitors use, and risk of acute kidney injury: a meta-analysis of observational studies

Yi Yang  1 , Kaisha C George  1 , Wei-Feng Shang  2 , Rui Zeng  1 , Shu-Wang Ge  1 , Gang Xu  1
Affiliations
Meta-Analysis

Proton-pump inhibitors use, and risk of acute kidney injury: a meta-analysis of observational studies

Yi Yang et al. Drug Des Devel Ther. .

Abstract

Background: Recent studies have suggested a potential increased risk of acute kidney injury (AKI) among proton-pump inhibitor (PPI) users. However, the present results are conflicting. Thus, we performed a meta-analysis to investigate the association between PPI therapy and the risk of AKI.

Methods: EMBASE, PubMed, Web of Science, and Cochrane Library databases (up to September 23, 2016) were systematically searched for any studies assessing the relationship between PPI use and risk of AKI. Studies that reported relevant risk ratios (RRs), odds ratios, or hazard ratios were included. We calculated the pooled RRs with 95% confidence intervals (CI) using a random-effects model of the meta-analysis. Subgroup analysis was conducted to explore the source of heterogeneity.

Results: Seven observational studies (five cohort studies and two case-control studies) were identified and included, and a total of 513,696 cases of PPI use among 2,404,236 participants were included in the meta-analysis. The pooled adjusted RR of AKI in patients with PPIs use was 1.61 (95% CI: 1.16-2.22; I2=98.1%). Furthermore, higher risks of AKI were found in the subgroups of cohort studies, participant's average age <60 years, participants with and without baseline PPI excluded, sample size <300,000, and number of adjustments ≥11. Subgroup analyses revealed that participants with or without baseline PPI excluded might be a source of heterogeneity.

Conclusion: PPI use could be a risk factor for AKI and should be administered carefully. Nevertheless, some confounding factors might impact the outcomes. More well-designed prospective studies are needed to clarify the association.

Keywords: acute kidney injury; meta-analysis; proton-pump inhibitor; risk.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of selection of studies. Abbreviations: AKI, acute kidney injury; PPI, proton-pump inhibitor.
Figure 2
Figure 2
Association between proton-pump inhibitors use and risk of acute kidney injury. Note: Weights are from random-effects analysis. Abbreviations: ARIC, atherosclerosis risk in communities; CI, confidence interval; GHS, Geisinger Health System; RR, risk ratio.
See this image and copyright information in PMC

References

    1. Robinson M, Horn J. Clinical pharmacology of proton pump inhibitors: what the practising physician needs to know. Drugs. 2003;63(24):2739–2754. - PubMed
    1. Grace Newsome E, American College of Rheumatology Guidelines for the management of rheumatoid arthritis: 2002 update. J Am Acad Nurse Pract. 2002;14(10):432–437. - PubMed
    1. Bateman DN, Colin-Jones D, Hartz S, et al. Mortality study of 18,000 patients treated with omeprazole. Gut. 2003;52(7):942–946. - PMC - PubMed
    1. Boparai V, Rajagopalan J, Triadafilopoulos G. Guide to the use of proton pump inhibitors in adult patients. Drugs. 2008;68(7):925–947. - PubMed
    1. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006;296(24):2947–2953. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources