Impact of proton pump inhibitor and non-steroidal anti-inflammatory drug use on renal function and chronic kidney disease progression

Abstract

Objectives To determine the prevalence and use rates of proton pump inhibitor (PPI), nonsteroidal anti-inflammatory drug (NSAID), and the combination of both drugs in the chronic kidney disease (CKD) population, examine their prescribing patterns, and ascertain their impact on renal function and CKD progression. Material and Methods The study included patients with CKD. Within the group, creatinine levels and eGFR from baseline to 3 months and between groups, creatinine levels and eGFR at baseline and 3 months were compared using the Wilcoxon signed ranks and Kruskal-Wallis tests, respectively. Logistic regression was used to determine CKD progression risk at 3 months. Results The prevalence rates of use of PPI only, NSAID only, and the combination of both drugs in the study population were 15.3%, 14.0%, and 11.0%, respectively. Omeprazole (82.7%) and diclofenac (40.0%) were the most frequently prescribed PPI and NSAID, respectively. PPIs or NSAIDs significantly increased and decreased creatinine levels and eGFR, respectively, although these were significantly greater with the combination of both drugs ( p <0.05). Conclusion This study demonstrates considerable use of PPI or NSAID or both drugs among patients with CKD, which can significantly impair renal function. Care should be observed when prescribing them for this high-risk group. Kidney function should be checked regularly, and the concurrent use of both drug classes should be minimized whenever possible to decrease the risk of further kidney impairment.