The Effect of Proton Pump Inhibitor Use on Renal Function in Kidney Transplanted Patients
<p>Trend in mean estimated glomerular filtration rate (eGFR). Mean eGFR is plotted against time in the two patient groups. Grouping is according to PPI intake or non-intake at half a year post-transplantation.</p> "> Figure 2
<p>Results of the biopsy proven rejection analyses are shown. Grouping is according to PPI intake (pantoprazole equivalent) in the relevant time period. Rejection prevalence is shown as absolute number and as percentage of patients in the group. The dark part of each bar represents the number of patients with rejections. Abbreviations: <span class="html-italic">n</span>, total number of patients in the group; Rej, number of patients who experienced a graft rejection; pTx, post transplantation. (<b>A</b>) Analysis of rejections in months 1–6 pTx. (<b>B</b>) Analysis of rejections in months 7–12 pTx. (<b>C</b>) Analysis of rejections months 13–24 pTx.</p> "> Figure 2 Cont.
<p>Results of the biopsy proven rejection analyses are shown. Grouping is according to PPI intake (pantoprazole equivalent) in the relevant time period. Rejection prevalence is shown as absolute number and as percentage of patients in the group. The dark part of each bar represents the number of patients with rejections. Abbreviations: <span class="html-italic">n</span>, total number of patients in the group; Rej, number of patients who experienced a graft rejection; pTx, post transplantation. (<b>A</b>) Analysis of rejections in months 1–6 pTx. (<b>B</b>) Analysis of rejections in months 7–12 pTx. (<b>C</b>) Analysis of rejections months 13–24 pTx.</p> ">
Abstract
:1. Introduction
2. Patients and Methods
2.1. Patients
2.2. Proton Pump Inhibitors—Data Collection
2.3. Group Formation
2.4. Outcome Measures
2.5. Statistical Analysis
3. Results
3.1. Patients
3.2. Group Comparison
3.3. >30% and >50% eGFR Decline
3.4. Secondary Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Patient Characteristic | All Patients (n = 455) | PPI Group (n = 363) | No PPI Group (n = 82) | p-Value of Group Comparison |
---|---|---|---|---|
Recipient age, mean ± SD (years) | 52.6 ± 14.2 | 53.1 ± 13.9 | 49.3 ± 14.5 | 0.026 |
Recipient male gender, n (%) | 279 (61.3) | 219 (60.3) | 52 (63.4) | 0.707 |
Recipient BMI, mean ± SD (kg/m2) | 25.9 ± 4.4 | 26.0 ± 4.3 | 24.9 ± 4.5 | 0.053 |
Prior renal transplantation, n (%) | 64 (14.1) | 45 (12.4) | 16 (19.5) | 0.109 |
Age of donor, mean ± SD (years) | 53.1 ± 14.0 | 53.3 ± 14.4 | 51.4 ± 11.9 | 0.204 |
Living donor, n (%) | 153 (33.6) | 112 (30.9) | 41 (50.0) | 0.001 |
Male donor, n (%) | 208 (45.7) | 170 (46.8) | 33 (40.2) | 0.326 |
Delayed graft function, n (%) | 79 (17.4) | 59 (16.3) | 11 (13.4) | 0.616 |
European Senior Program, n (%) | 76 (16.7) | 62 (17.1) | 10 (12.2) | 0.322 |
Cold ischemia time (hours), median (IQR) | 7.8 (2.5–11.6) | 7.8 (2.7–11.7) | 5.2 (2.3–11.1) | 0.053 |
Pre-Tx time dialyzed (months), median (IQR) | 45.3 (21.0–86.0) | 48.2 (23.2–88.5) | 32.4 (8.6–67.2) | 0.002 |
Tacrolimus therapy at primary discharge, n (%) | 432 (94.9) | 347 (95.6) | 76 (92.7) | 0.265 |
Cyclosporin therapy at primary discharge, n (%) | 23 (5.1) | 16 (4.4) | 6 (7.3) | 0.265 |
MPS therapy at primary discharge, n (%) | 76 (16.7) | 57 (15.7) | 18 (22.0) | 0.191 |
MMF therapy at primary discharge, n (%) | 341 (74.9) | 278 (76.6) | 57 (69.5) | 0.200 |
MMF mean daily dosage (mg), median (IQR) | 1000 (500–1000) | 1000 (500–1000) | 1000 (0–1063) | 0.851 |
Cortisone intake at primary discharge, n (%) | 444 (97.6) | 353 (97.2) | 81 (98.8) | 0.698 |
CCI, median (IQR) | 2 (2–4) | 3 (2–4) | 2 (2–3) | <0.001 |
HLA mismatch on A, B and DR, mean ± SD | 2.9 ± 1.7 | 2.9 ± 1.7 | 2.9 ± 1.7 | 0.875 |
Basiliximab induction, n (%) | 363 (79.8) | 293 (80.7) | 61 (74.4) | 0.272 |
ATG induction, n (%) | 14 (3.1) | 13 (3.6) | 1 (1.2) | 0.482 |
ABO blood type incompatible transplant, n (%) | 37 (8.1) | 26 (7.2) | 11 (13.4) | 0.077 |
PRA >20%, n (%) | 60 (13.2) | 48 (13.2) | 10 (12.2) | 1.000 |
Time Period of Analyzed eGFR Change | Groups 1 = PPI 0 = No PPI | n | Mean Change in the eGFR ± SD (mL/min/1.73 m2) | Median (IQR) Change in the eGFR | p-Value in Univariable Analysis | p-Value (CI) in Multivariable Linear Regression Model |
---|---|---|---|---|---|---|
0.5–1 year | 1 | 323 | −0.6 ± 12.0 | 1.0 (−6.0–6.5) | 0.488 | 0.498 (−1.9–3.8) |
0 | 78 | −0.5 ± 8.3 | −0.5 (−5.6–4.4) | |||
0.5–2 years | 1 | 310 | −1.6 ± 14.2 | 0.2 (−9.0–7.5) | 0.274 | 0.542 (−2.3–4.5) |
0 | 74 | −2.4 ± 10.2 | −1.5 (−9.2–5.2) | |||
0.5–3 years | 1 | 202 | −0.8 ± 15.1 | 0.35 (−8.0–8.4) | 0.331 | 0.452 (−2.6–5.8) |
0 | 58 | −2.5 ± 11.0 | −1.3 (−7.0–5.4) | |||
0.5–4 years | 1 | 125 | −0.1 ± 14.5 | −0.1 (−7.3–8.6) | 0.101 | 0.228 (−2.2–9.1) |
0 | 28 | −4.2 ± 9.1 | −1.7 (−10.5–2.9) |
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Flothow, D.J.G.; Suwelack, B.; Pavenstädt, H.; Schütte-Nütgen, K.; Reuter, S. The Effect of Proton Pump Inhibitor Use on Renal Function in Kidney Transplanted Patients. J. Clin. Med. 2020, 9, 258. https://doi.org/10.3390/jcm9010258
Flothow DJG, Suwelack B, Pavenstädt H, Schütte-Nütgen K, Reuter S. The Effect of Proton Pump Inhibitor Use on Renal Function in Kidney Transplanted Patients. Journal of Clinical Medicine. 2020; 9(1):258. https://doi.org/10.3390/jcm9010258
Chicago/Turabian StyleFlothow, Dominik J. G., Barbara Suwelack, Hermann Pavenstädt, Katharina Schütte-Nütgen, and Stefan Reuter. 2020. "The Effect of Proton Pump Inhibitor Use on Renal Function in Kidney Transplanted Patients" Journal of Clinical Medicine 9, no. 1: 258. https://doi.org/10.3390/jcm9010258