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Minerva Urology and Nephrology 2021 Mar 26

DOI: 10.23736/S2724-6051.21.04116-3


language: English

Proton pump inhibitors use and risk of chronic kidney disease and end-stage renal disease: systematic review and meta-analysis

Carolina S. VENGRUS 1, Vinícius D. DELFINO 1, 2, Paulo R. BIGNARDI 1

1 School of Medicine, Pontifícia Universidade Católica do Paraná, Londrina, Brazil; 2 Universidade Estadual de Londrina, Londrina, Brazil


A possible association between long-term Proton Pump Inhibitors (PPI) use and Chronic Kidney Disease (CKD) has been recently described. Due to the potential health risk of this association, in the absence of proper clinical trials, we have decided to carry out a systematic review followed by meta-analysis. PubMed, Cochrane Library, and Lilacs databases were searched. Studies that reported an association between PPI use and CKD or End-stage Renal Disease (ESRD) published until December 23, 2019, were included. All selected studies present high quality according to the New-Castle-Ottawa. The risk ratio (RR) and confidence interval (CI) were pooled using a random-effects model in CKD outcome analysis and fixed effects model for ESRD. A total of 10 observational studies were selected. Compared to patients who did not use PPI, the RR for CKD associated with PPI use was 1.35 (95% CI 1.15 - 1.56) with p<0,001, and the RR for ESRD associated with PPI use was 1.49 (95% CI 1.41 - 1.56) with p<0,001. This study indicates the presence of a significant association between PPI use and an increased risk of CKD and ESRD and reiterates the need for the medical prescription of this class of drugs to be made following the guidelines of the FDA.

KEY WORDS: Chronic kidney diseases; Digestive system diseases; Kidney diseases; Meta-analysis; Proton pump inhibitors

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