NKF 2019—Unnecessary and risky PPIs used in one-quarter of patients with CKD


  • Richard Robinson
  • Conference Reports
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Takeaway

  • One-quarter of patients with chronic kidney disease (CKD) receive proton pump inhibitors (PPIs) without having a US Food and Drug Administration (FDA)-approved indication.

Why this matters

  • PPIs increase the risk of acute kidney injury, development of CKD, and progression to end-stage renal disease.
  • Reduction in unnecessary use in patients with CKD has the potential to improve health and reduce costs.

Study design

  • Retrospective chart review in a Veterans Affairs outpatient nephrology clinic.
  • Patients were included who had an estimated glomerular filtration rate of 2.
  • Patients were characterized as having or not having an approved indication for use of PPIs, based on FDA and American College of Gastroenterology guidelines.

Key results

  • Of 91 patients with CKD, 22 had a PPI indication, of whom 13 were using a PPI.
  • Of the 69 patients without an indication, 24 (35%, or 26% of the total population) were using a PPI.
  • There was no difference in the duration of use for patients with vs without an indication (331 vs 319 days, P=.80).

Limitations

  • Single-center, retrospective study.