Highlights
- •It is not unclear if proton pump inhibitor (PPI) use is associated with subsequent risk of impaired renal function or the development or progression of albuminuria in patients with diabetes.
- •PPI use is not associated with the subsequent risk of estimated glomerular filtration rate decline.
- •PPI use is not also associated with the development nor progression of albuminuria in patients with diabetes.
Abstract
Aims
We aimed to determine the prospective association between proton pump inhibitor (PPI)
use and the subsequent risk of the development or progression of albuminuria or eGFR.
Methods
Longitudinal data of patients with diabetes were obtained from a large Japanese diabetes
registry. To assess the independent correlation between PPI use and the development
or progression of urine microalbuminuria, the time-varying Cox proportional hazards
model was used with adjustment for potential confounders.
Results
The mean patient age, body-mass index (BMI), and hemoglobin A1c (HbA1c) levels were
65.7 y, 24.5 kg/m2, and 7.5% (57.9 mmol/mol), respectively. In 1711 patients without albuminuria, we
observed 599 cases with development of albuminuria over median follow-up of 4.0 years,
and in 1279 patients with microalbuminuria, 290 cases with urinary albuminuria progression
over 4.0 years, and 257 eGFR decline cases over 3.8 years. PPI use was not associated
with the development of albuminuria (HR = 0.88; 95%CI, 0.77–1.01; p = .058), progression
of albuminuria (HR = 1.24; 95%CI, 0.87–1.79; p = .236), nor eGFR decline (HR = 1.05;
95%CI, 0.81–1.34; p = .973) even in a propensity score-adjusted model with time-varyingly
updating PPI use information.
Conclusions
In conclusion, PPI use was not associated with the subsequent risk of development
or progression of albuminuria, or eGFR decline in patients with diabetes.
Keywords
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Article info
Publication history
Published online: February 03, 2018
Accepted:
January 23,
2018
Received in revised form:
December 21,
2017
Received:
June 25,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
