The Effects of Pantoprazole on Kidney Outcomes

作者：Lonnie Pyne, Andrew Smyth, Amber O. Molnar, Paul Moayyedi, Eva Muehlhofer, Salim Yusuf, John W. Eikelboom, Jackie Bosch, Michael Walsh · 发表于：Journal of the American Society of Nephrology · 年份：2024 · DOI：10.1681/asn.0000000000000356 · 被引用次数：13 · 研究领域：Chronic Kidney Disease and Diabetes、Renal Diseases and Glomerulopathies、Antiplatelet Therapy and Cardiovascular Diseases

Key Points In this post hoc analysis of a randomized controlled trial, the proton pump inhibitor pantoprazole led to a faster rate of eGFR decline as compared with placebo. Additional studies are needed to determine the effect of proton pump inhibitors on those at higher risk of adverse kidney outcomes. Background Observational studies have found an association between proton pump inhibitor use and worsening kidney function. It is unclear whether these associations are causal. We conducted post hoc analyses to determine the effect of pantoprazole on kidney function using data from the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial, a 17,598-participant randomized trial comparing pantoprazole (8791) with placebo (8807). Methods The primary outcome was the rate of eGFR change. Rate of eGFR change was based on the two eGFR measures available: the eGFR at randomization and at the open-label extension study that enrolled at trial conclusion. Secondary outcomes included incident CKD (defined by eGFR <60 ml/min per 1.73 m 2 at open-label extension or case report forms) as well as AKI, acute nephritis, and nephrotic syndrome. Results Eight thousand nine hundred ninety-one of the 17,598 participants randomized to pantoprazole/placebo (51%) had eGFR recorded at baseline and open-label extension enrollment and were included in the rate of eGFR change population (mean age 67 [SD 8] years, 22% female, mean baseline eGFR 75 [SD 17.5] ml/min per 1.73 ...