A US study concluded that proton pump inhibitor (PPI) use is associated with a higher risk of incident chronic kidney disease (CKD). A total of 10 482 participants with a normal renal function were followed from a baseline visit between February 1, 1996, and January 30, 1999, to December 31, 2011. The data was analyzed from May 2015 to October 2015. The findings were replicated in an administrative cohort of 248 751 patients with a normal renal function. Compared with nonusers, PPI users were more often of white race, obese, and taking antihypertensive medication. Proton pump inhibitor use was associated with incident CKD in unadjusted analysis; in analysis adjusted for demographic, socioeconomic, and clinical variables and in analysis with PPI ever use modeled as a time-varying variable. The association persisted when baseline PPI users were compared directly with H2 receptor antagonist users (for the same indication as PPIs) and with propensity score–matched nonusers. In the replication cohort, PPI use was associated with CKD in all analyses, including a time-varying new-user design. Twice-daily PPI dosing was associated with a higher risk than once-daily dosing. PPIs are among the most commonly used drugs worldwide and have been linked to acute interstitial nephritis, hypomagnesemia, infections, and osteoporotic fracture. Source: http://archinte.jamanetwork.com/
美国一项研究得出的结论是质子泵抑制剂的使用与慢性肾脏病的风险较高有关。对总共10 482名肾功能正常的参与者从1996年2月1日和1999年1月30日随访至2011年12月31日。2015年5月至10月间对数据进行了分析。该调查结果在248 751名肾功能正常的管理群组患者中得以复制。与未使用者相比，服用质子泵抑制剂者较多为白人，肥胖和服用降压药者。在未经校正的分析， 经校正人口，社会经济地位和临床变量的分析，和在应用质子泵抑制剂随时间变化的变量分析中，质子泵抑制剂的使用均与慢性肾脏病的发生有关。当基线质子泵抑制剂服用者与H2受体拮抗剂服用者（与质子泵抑制剂适应症相同）或与倾向得分匹配的非使用者直接进行比较仍然相关。在复制群组，质子泵抑制剂的使用与慢性肾脏病在所有的分析中均相关，包括在随时间变化的新应用者的设计条件下。每日两次质子泵抑制剂给药比每日一次给药风险更高。 质子泵抑制剂是世界范围内最常用的药物之一，与急性间质性肾炎，低镁血症，感染和骨质疏松性骨折有关。来源：http://archinte.jamanetwork.com/