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Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis

Data to draw definite conclusions regarding the association between proton pump inhibitor (PPI) and all-cause mortality in patients undergoing hemodialysis (HD) remain insufficient. The object of this retrospective study was to assess the impact of PPIs on patient survival within a substantial cohor...

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Autores principales: Kang, Seok Hui, Kim, Gui Ok, Kim, Bo Yeon, Son, Eun Jung, Do, Jun Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381393/
https://www.ncbi.nlm.nih.gov/pubmed/37510864
http://dx.doi.org/10.3390/jcm12144749
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author Kang, Seok Hui
Kim, Gui Ok
Kim, Bo Yeon
Son, Eun Jung
Do, Jun Young
author_facet Kang, Seok Hui
Kim, Gui Ok
Kim, Bo Yeon
Son, Eun Jung
Do, Jun Young
author_sort Kang, Seok Hui
collection PubMed
description Data to draw definite conclusions regarding the association between proton pump inhibitor (PPI) and all-cause mortality in patients undergoing hemodialysis (HD) remain insufficient. The object of this retrospective study was to assess the impact of PPIs on patient survival within a substantial cohort of individuals receiving maintenance HD. To achieve this, the study employed laboratory and clinical data sourced from the 4th, 5th, and 6th National HD Quality Assessment Programs. The programs included patients undergoing maintenance HD (n = 54,903). Based on the PPI prescription data collected over the 6-month HD quality assessment, the patients were categorized into three groups: Group 1, comprising individuals with not prescription; Group 2, consisting of patients prescribed PPIs for less than 90 days; and Group 3, comprising patients prescribed PPIs for 90 days or more. The respective number of patients in Groups 1, 2, and 3 was 43,059 (78.4%), 5065 (9.2%), and 6779 (12.3%), respectively. Among the study groups, the 5-year survival rates were as follows: Group 1—70.0%, Group 2—68.4%, and Group 3—63.0%. The hazard ratio for Group 3 was 1.09 (95% CI, 1.04 to 1.15; p < 0.001) and 1.10 (95% CI, 1.03 to 1.18; p = 0.007) compared to Groups 1 or 2 based on multivariable analysis. Multivariable analyses revealed a lower rate of patient survival in Group 3 compared to the other groups, while Groups 1 and 2 exhibited similar patient survival rates. Our study revealed a significant association between long-term PPI usage and increased mortality among patients undergoing HD. However, distinct trends were observed in subgroup analyses. The association between long-term PPI usage and mortality was prominent in patients who did not have a high gastrointestinal burden or comorbidities. Meanwhile, this association was not observed in patients who did have a high gastrointestinal burden or comorbidities.
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spelling pubmed-103813932023-07-29 Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis Kang, Seok Hui Kim, Gui Ok Kim, Bo Yeon Son, Eun Jung Do, Jun Young J Clin Med Article Data to draw definite conclusions regarding the association between proton pump inhibitor (PPI) and all-cause mortality in patients undergoing hemodialysis (HD) remain insufficient. The object of this retrospective study was to assess the impact of PPIs on patient survival within a substantial cohort of individuals receiving maintenance HD. To achieve this, the study employed laboratory and clinical data sourced from the 4th, 5th, and 6th National HD Quality Assessment Programs. The programs included patients undergoing maintenance HD (n = 54,903). Based on the PPI prescription data collected over the 6-month HD quality assessment, the patients were categorized into three groups: Group 1, comprising individuals with not prescription; Group 2, consisting of patients prescribed PPIs for less than 90 days; and Group 3, comprising patients prescribed PPIs for 90 days or more. The respective number of patients in Groups 1, 2, and 3 was 43,059 (78.4%), 5065 (9.2%), and 6779 (12.3%), respectively. Among the study groups, the 5-year survival rates were as follows: Group 1—70.0%, Group 2—68.4%, and Group 3—63.0%. The hazard ratio for Group 3 was 1.09 (95% CI, 1.04 to 1.15; p < 0.001) and 1.10 (95% CI, 1.03 to 1.18; p = 0.007) compared to Groups 1 or 2 based on multivariable analysis. Multivariable analyses revealed a lower rate of patient survival in Group 3 compared to the other groups, while Groups 1 and 2 exhibited similar patient survival rates. Our study revealed a significant association between long-term PPI usage and increased mortality among patients undergoing HD. However, distinct trends were observed in subgroup analyses. The association between long-term PPI usage and mortality was prominent in patients who did not have a high gastrointestinal burden or comorbidities. Meanwhile, this association was not observed in patients who did have a high gastrointestinal burden or comorbidities. MDPI 2023-07-18 /pmc/articles/PMC10381393/ /pubmed/37510864 http://dx.doi.org/10.3390/jcm12144749 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kang, Seok Hui
Kim, Gui Ok
Kim, Bo Yeon
Son, Eun Jung
Do, Jun Young
Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
title Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
title_full Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
title_fullStr Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
title_full_unstemmed Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
title_short Effects of Proton Pump Inhibitors on Patient Survival in Patients Undergoing Maintenance Hemodialysis
title_sort effects of proton pump inhibitors on patient survival in patients undergoing maintenance hemodialysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381393/
https://www.ncbi.nlm.nih.gov/pubmed/37510864
http://dx.doi.org/10.3390/jcm12144749
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