Association Between Proton Pump Inhibitors Use And Kidney Diseases:a Meta-analysis

Background Recent epidemiologic studies attempting to demonstrate the risk of kidney diseases among patients with proton pump inhibitors(PPIs)use are conflicting.Therefore,We conducted a meta-analysis of published clinical studies to assess the relevance of them.Methods We searched EMBASE,the Cochrane Central Register of Controlled Trials databases,Pub Med,Medline ? China national knowledge infrastructure,VIP database ?Wanfang database?China Basketball Museum and the reference lists of relevant articles to identify clinical observational studies that reported odd ratios or hazard ratios comparing the risk of kidney diseases in patients with PPIs use.A meta-analysis of published clinical studies was conducted.Results A total of 9 articles included five case-control and five cohort studies(n= 2,484,924participants)were eventually identified in this meta-analysis.In comparison with the patients who did not use PPI,the pooled risk ratio(RR)for patients with kidney diseases including acute interstitial nephritis(AIN),acute kidney injury(AKI),chronic kidney disease(CKD),and end stage renal disease(ESRD)were 3.76(95% CI,2.36-5.99),1.61(95%CI,1.16-2.22),1.20(95%CI,1.09-1.32),and 1.88(95%CI,1.72-2.06),respectively.Conclusions The use of proton pump inhibitors increases the risk of adverse kidney outcomes,such as AIN,AKI,CKD and ESRD.This finding provides an effective way to stimulate the development of more effective prevention and treatment measures.At the same time,it also has a guiding role for clinicians to use proton pump inhibitors rationally.