Study: Proton pump inhibitors may increase risk of AKI after cardiac surgery
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Patients who took proton pump inhibitors (PPIs) before cardiac surgery may be at an elevated risk for developing AKI, according to data presented at ASN Kidney Week.
“Based on this study, proton pump inhibitors could be considered as a modifiable risk factor for postoperative acute kidney injury,” Hee Byung Koh, MD, from the Institute of Kidney Disease Research at Yonsei University, Seoul, said during the virtual meeting.
In the retrospective study, researchers studied two groups of patients based on hospital-based electronic medical record and health insurance information. The 6,555 patients in the Severance cardiac surgery cohort had cardiac surgery between 2011 and 2020. The 2,939 patients in the National Health Insurance Service senior cohort underwent cardiac surgery between 2004 and 2015.
Patients in both groups were age 18 years and older. Researchers defined preoperative PPI exposure as a PPI prescription record within 3 weeks before cardiac surgery.
In the Severance cardiac surgery cohort, the rate of AKI requiring dialysis was 5.5% in patients who used PPIs and 3.2% in patients who did not. In-hospital mortality rates were 4.7% and 3.2%, respectively.
After adjustments, PPI use was linked with a 2.2-times higher odds of developing AKI requiring dialysis and a 1.53-times higher odds of dying during hospitalization. The other cohort revealed comparable findings, showing that PPI use was linked with 2.29-times higher odds of AKI requiring dialysis and 2.25-times higher odds of in-hospital mortality.
“PPI exposure was associated with an increased risk for AKI dialysis compared with non-exposure. The association between PPI exposure and AKI could mediate interstitial nephritis,” he said.
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Koh HB, et al. Paper TH-OR05. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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