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Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients


Autoři: Sayaka Maeda aff001;  Makoto Yamaguchi aff002;  Kunihiro Maeda aff001;  Naoto Kobayashi aff001;  Naoki Izumi aff001;  Masaaki Nagai aff001;  Takaaki Obayashi aff001;  Wataru Ohashi aff003;  Takayuki Katsuno aff002;  Hironobu Nobata aff002;  Yasuhiko Ito aff002
Působiště autorů: Department of Nephrology, Narita Memorial Hospital, Toyohashi, Japan aff001;  Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute, Japan aff002;  Division of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute, Japan aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224859

Souhrn

Peritonitis is a major and the most significant complication of peritoneal dialysis (PD). Although some predictors of peritonitis in PD patients are known, the association between proton pump inhibitor (PPI) use and peritonitis has not been characterized. Here, we examined whether PPI use is a risk factor for the development of peritonitis, based on a single-center retrospective analysis of 230 consecutive Japanese PD patients at Narita Memorial Hospital. We assessed the association between PPI use and subsequent first episode of peritonitis using multivariate Cox proportional hazards models, following adjustment for clinically relevant factors. The median follow-up period was 36 months (interquartile range, 19–57 months). In total, 86 patients (37.4%) developed peritonitis. Analysis with multivariate Cox proportional hazards models revealed the following significant predictors of peritonitis: PPI use (adjusted hazard ratio [HR] = 1.72, 95% confidence interval [CI]: 1.11–2.66; P = 0.016) and low serum albumin level (per g/dl adjusted HR = 0.59, 95% CI: 0.39–0.90; P = 0.014). Thus, PPI use was independently associated with PD-related peritonitis. The results suggest that nephrology physicians should exercise caution when prescribing PPIs for PD patients.

Klíčová slova:

Medical risk factors – Medical dialysis – Effluent – Peritonitis – Serum albumin – Proton pumps


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