Evidence map›Paper›PMID 36451129›Full record

ArticleBMC nephrology2022

Use of proton pump inhibitors and macrolide antibiotics and risk of acute kidney injury: a self-controlled case series study.

Keiko Ikuta, Shunsaku Nakagawa, Chinami Yamawaki, Kotaro Itohara, Daiki Hira, Satoshi Imai, Atsushi Yonezawa, Takayuki Nakagawa, Minoru Sakuragi, Noriaki Sato and 3 more

Open access · goldAbstract read
In one paragraph

Article in BMC nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.0field-weighted citation impact, top 12% 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

7 citing papers in PubMed, 14 citations in OpenAlex.

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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

13 authors at 2 institutions in 1 country.

Keiko IkutaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Shunsaku NakagawaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan. nakashun@kuhp.kyoto-u.ac.jp.
Chinami YamawakiDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Kotaro ItoharaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Daiki HiraDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Satoshi ImaiDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Atsushi YonezawaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Takayuki NakagawaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Minoru SakuragiDepartment of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Noriaki SatoDepartment of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Eiichiro UchinoDepartment of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Motoko YanagitaDepartment of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Tomohiro TeradaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Kyoto University Hospital · JPKyoto University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal disorders such as peptic ulcer disease and dyspepsia. However, several studies have suggested that PPI use increases the risk of acute kidney injury (AKI). PPIs are often concomitantly used with antibiotics, such as macrolides and penicillins for Helicobacter pylori eradication. Although macrolide antibiotics are considered to have relatively low nephrotoxicity, they are well known to increase the risk of AKI due to drug-drug interactions. In this study, we aimed to investigate the association between PPI use and the development of AKI. We also evaluated the effect of concomitant use of PPIs and macrolide antibiotics on the risk of AKI.

methodsThis self-controlled case series study was conducted using electronic medical records at Kyoto University Hospital. We identified patients who were prescribed at least one PPI and macrolide antibiotic between January 2014 and December 2019 and underwent blood examinations at least once a year. An adjusted incident rate ratio (aIRR) of AKI with PPI use or concomitant use macrolide antibiotics with PPIs was estimated using a conditional Poisson regression model controlled for the estimated glomerular filtration rate at the beginning of observation and use of potentially nephrotoxic antibiotics.

resultsOf the 3,685 individuals who received PPIs and macrolide antibiotics, 766 patients with episodes of stage 1 or higher AKI were identified. Any stage of AKI was associated with PPI use (aIRR, 1.80 (95% confidence interval (CI) 1.60 to 2.04)). Stage 2 or higher AKI was observed in 279 cases, with an estimated aIRR of 2.01 (95% CI 1.57 to 2.58, for PPI use). For the period of concomitant use of macrolide antibiotics with PPIs compared with the period of PPIs alone, an aIRR of stage 1 or higher AKI was estimated as 0.82 (95% CI 0.60 to 1.13).

conclusionsOur findings added epidemiological information for the association between PPI use and an increased risk of stage 1 or higher AKI. However, we did not detect an association between the concomitant use of macrolide antibiotics and an increased risk of AKI in PPI users.

Indexed as

Acute Kidney InjuryProton Pump InhibitorsAnti-Bacterial AgentsHumansMacrolidesResearch DesignAnti-Bacterial AgentsMacrolidesProton Pump InhibitorsAcute kidney injuryMacrolide antibioticsProton pump inhibitorSelf-controlled case series study

Identifiers

PMID36451129
PMCPMC9710142
OpenAlexW4310999233

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Registered trials

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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.