肾结石
医学
危险系数
格尔德
内科学
比例危险模型
尿
泌尿系统
回流
质子抑制剂泵
肾脏疾病
胃肠病学
肾结石病
泌尿科
置信区间
疾病
作者
Wilson Sui,Nicole Miller,Edward R. Gould,Kevin C. Zhang,Tatsuki Koyama,Ryan S. Hsi
出处
期刊:Urolithiasis
[Springer Nature]
日期:2022-05-02
卷期号:50 (4): 401-409
被引量:4
标识
DOI:10.1007/s00240-022-01326-1
摘要
Proton pump inhibitors (PPIs) are widely prescribed medications that have effects on both enteric and urinary solute handling with an unknown effect on risk of nephrolithiasis. Our objectives were to examine the association between PPI exposure and incident nephrolithiasis and to determine its effect on 24H urine chemistry. We performed a single-center retrospective study on patients diagnosed with gastroesophageal reflux disease (GERD) without a history of kidney stones. Exposure to PPIs was abstracted, and then subsequent kidney stone diagnoses were identified. Multivariable Cox models with time-varying covariates were used to estimate the hazard of PPI use on incident nephrolithiasis. We used multivariable linear regression to analyze a subset of patients who went through 24-h urine analysis. We identified n = 55,765 PPI-naïve GERD patients without prior kidney stone diagnoses of whom 40,866 (73.2%) were exposed to PPI over a median of 3 year follow up. On multivariable analysis, PPI use was associated with higher risk of incident kidney stone diagnoses (HR 1.19, 95% CI 1.06–1.34). Among 593 patients with GERD with 24-H urine data, the PPI-exposed group (n = 307) had significantly lower mean urinary citrate (mean 3.0 vs 3.4 mmol, p = 0.029) and urinary magnesium (mean 3.6 vs 4.3 mmol, p < 0.001) on multivariable analyses. Exposure to PPIs is associated with an increased risk of kidney stones among patients with GERD. Hypomagnesemia and hypocitraturia associated with PPI exposure may contribute to kidney stone risk.
科研通智能强力驱动
Strongly Powered by AbleSci AI