Evidence map›Paper›PMID 34266395›Full record

ArticleBMC nephrology2021

Proton-pump inhibitor vs. H2-receptor blocker use and overall risk of CKD progression.

Liza Cholin, Tarek Ashour, Ali Mehdi, Jonathan J Taliercio, Remy Daou, Susana Arrigain, Jesse D Schold, George Thomas, Joseph Nally, Nazih L Nakhoul and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023
    Guideline
  4. Article
  5. [Resilience is job satisfaction using nephrology as an example].Innere Medizin (Heidelberg, Germany) · 2025
    Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Observational
  11. Article
  12. Article
  13. Rebuilding trust in proton pump inhibitor therapy.World journal of gastroenterology · 2022
    Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Liza CholinCleveland Clinic, Cleveland, OH, USA. cholinl@ccf.org.
Tarek AshourCleveland Clinic, Cleveland, OH, USA.
Ali MehdiCleveland Clinic, Cleveland, OH, USA.
Jonathan J TaliercioCleveland Clinic, Cleveland, OH, USA.
Remy DaouSaint-Joseph University, Beirut, Lebanon.
Susana ArrigainCleveland Clinic, Cleveland, OH, USA.
Jesse D ScholdCleveland Clinic, Cleveland, OH, USA.
George ThomasCleveland Clinic, Cleveland, OH, USA.
Joseph NallyCleveland Clinic, Cleveland, OH, USA.
Nazih L NakhoulTulane University School of Medicine, New Orleans, LA, USA.
Georges N NakhoulCleveland Clinic, Cleveland, OH, USA.
Cleveland Clinic · USSaint Joseph University · LBTulane University · US

Funding

Membrane Transport of NH3 and NH4+R01DK062295 · NIDDK · TULANE UNIVERSITY OF LOUISIANA · PI NAKHOUL, NAZIH · 2003 to 2008
$1.5M
NIDDK NIH HHS R01 DK062295
6 · The paper itself

Abstract

backgroundThe relationship between proton-pump inhibitor (PPI) use and chronic kidney disease (CKD) progression remains controversial. Specifically, there is a lack of data evaluating renal outcomes in established CKD patients. The aim of our study is to determine the risk of progression to end-stage kidney disease (ESKD) or death amongst CKD patients on PPI, histamine-2 receptor blocker (H2B), or no anti-acid therapy.

methodsUsing our CKD registry, we evaluated the relationship between PPI and H2B use and outcomes amongst patients with CKD (eGFR < 60), with at least 2 PCP visits in the year prior. A Cox proportional hazards model was used to evaluate the relationship between medication groups and overall mortality, while competing risks regression models were used to determine the risk of ESKD with death as a competing risk.

results25,455 patients met inclusion criteria and were stratified according to medication group: no antacid therapy (15,961), PPI use (8646), or H2B use (848). At 4 years, the cumulative incidence of ESKD with death as a competing risk was 2.0% (95% CI: 1.7, 2.4), 1.5% (0.8, 2.8), and 1.6%(1.4, 1.9) among PPI, H2B, and no medication respectively (P = 0.22). The cumulative incidence of death with ESKD as a competing risk was 17.6% (95% CI: 16.6, 18.6), 16.7% (13.7, 19.8), and 17.3% (16.6, 18.0) (P = 0.71).

conclusionsUse of PPI in a CKD population was not associated with increased mortality or progression to ESKD when compared to H2 blocker and to no acid suppressing therapy.

Indexed as

Histamine H2 AntagonistsKidney Failure, ChronicProton Pump InhibitorsRenal Insufficiency, ChronicStomach DiseasesComorbidityDisease ProgressionFemaleHumansIncidenceKaplan-Meier EstimateMaleMiddle AgedNegative ResultsOutcome Assessment, Health CareProportional Hazards ModelsHistamine H2 AntagonistsProton Pump InhibitorsChronic kidney diseaseDisease progressionHistamine-2 receptor blockersMortalityProton-pump inhibitors

Identifiers

PMID34266395
PMCPMC8281649
OpenAlexW3180522792

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.