Proton Pump Inhibitor Use and the Risk of Chronic Kidney Disease

The goal of this study was to determine if there is an association between PPI use and incident chronic kidney disease (CKD) in the general population. Two cohorts were studied, the Atherosclerosis Risk in Communities (ARIC), a population based cohort (10,482 subjects followed for a median of 13.9 years) and the Geisinger Health System in Pennsylvania (248,751 subjects followed for a median of 6.2 years). In the ARIC cohort, after adjustment for confounders, the risk of incident CKD was 1.5 times greater in those taking PPIs at baseline compared to those who did not. The 10-year risk of CKD in PPI users at baseline was 11.8% whereas the expected risk (without PPI use) was 8.5%. In the Geisinger Health System cohort, the adjusted risk of incident CKD was 1.17 times greater in PPI users than in those who did not use PPIs. In addition, twice daily dosing of PPIs was associated with a greater risk of CKD than once daily dosing. This observational cohort study identified an association between PPI use and incident CKD, but does not provide evidence to prove causality.