Retrospective study of irrational use of proton pump inhibitor leading to chronic kidney disease.

Abstract

Millions of people worldwide take proton pump inhibitors (PPIs), which are available both with a prescription and over the counter for several months or even years, and some people take them permanently. Although these medications are usually thought to be safe, inappropriate prescribing can contribute to polypharmacy with its inherent risks of non adherence, prescribing cascades, adverse reactions, medication errors, drug interactions, emergency department visits, and hospitalizations.  In accordance with a growing body of research, PPI use is associated with a significantly elevated risk of doubling serum creatinine (Cr) levels, declining eGFR by more than 30%, and progressing to end-stage renal disease (ESRD) independent of AIN. These events may be linked to acute kidney injury, which may then result in chronic injury or kidney failure. We have carried out a retrospective analysis, using the creatinine measurements database, which includes data on diagnosis, dispensation claims, and laboratory test results for every resident in Eastern Gujarat. Once demographics, comorbidities, and concurrent medications were taken into account, baseline PPI use in this 1500-patient research was found to be independently linked to a 23.6% increased risk of incident CKD. When comparing long-term PPI users to those who use them occasionally, there was a higher risk of Acute Kidney Injury (AKI) in the former group. Additionally, this study highlights the negative effects and raises awareness about the prudent use of proton pump inhibitors around the globe. Practitioners who prescribe these medications should be aware of the risks associated with long-term CKD as well as short-term AKI and should also probably conduct some sort of surveillance, such as serum creatinine and/or urine tests while prescribing them. One possible strategy is to gradually reduce the dosage of PPIs by either stopping them completely or weaning them down, and then prescribing other options. Thus reducing the consequences of this financial and medical burden on healthcare systems.