Proton pump inhibitors use and the risk of chronic kidney disease: a
prospective cohort study
Background: Proton pump inhibitors (PPIs) are widely used worldwide and
have been linked to kidney diseases. However, it remains unclear about
the role of PPI use in the development of chronic kidney disease (CKD).
Aims: To examine the association between PPI use and risk of CKD.
Methods: This is a prospective analysis of 472,373 participants free of
any renal failure diagnosis from the UK Biobank. Incident CKD was
identified based on medical history and linkage to data on primary care
and hospital admissions. Self-reported PPI use was firstly assessed
using a touchscreen questionnaire, and then confirmed by a trained
staff. We estimated the hazard ratios (HRs) and confidence interval
(CIs) with Cox regression models adjusting for potential confounders.
The number needed to harm (NNH) was calculated at one and five years of
follow-up. Results We documented 7,291 cases of CKD over a median of 8.1
years follow-up. After adjustment for potential confounders, regular PPI
users had a 24% increased risk of CKD incident compared to non-regular
PPI users (HR1.24, 95%CI1.16 -1.33). The NNH was 773.1 and 177.5 for
one and five years of follow-up, respectively. Directly compared with H2
receptor antagonist, a less potent acid suppressor, PPI use was
associated with 17% higher risk of CKD (HR 1.17, 95% CI 1.00 to 1.36).
Conclusions Regular use of PPI is associated with an increased risk of
CKD. Healthcare providers should carefully weigh up the potential
benefits against risk in prescribing PPIs, particularly for long-term