The following is the summary of “Proton pump inhibitor usage associates with higher risk of first episodes of pneumonia and peritonitis in peritoneal dialysis patients” published in the December 2022 issue of Renal failure by Zhang, et al.
Proton pump inhibitors (PPIs) have been linked to infection in a number of studies. Therefore, researchers looked at the history of PD maintenance patients who were prescribed PPIs to see if there was any correlation between PPI use and the development of pneumonia or PD-related peritonitis. From January 1, 2012, through December 31, 2016, researchers gathered PD patients from 2 major hospitals and split them into 2 categories: those taking PPIs and those not taking PPIs. To assess the cumulative incidence and hazard ratios, multivariate Cox proportional hazards models were used (HRs) to assess the cumulative incidence and hazard ratios.
To further verify their results, researchers employed the Inverse Probability of Treatment Weight (IPTW) approach to correct for covariate imbalance between the 2 groups. Researchers analyzed data from 656 individuals with PD and found that PPI use was linked to an elevated incidence of pneumonia [HR 1.71; 95% CI 1.06-2.76; P=0.027] and peritonitis [HR 1.73; 95% CI 1.24-2.40; P=0.001]. PPIs were associated with an increased risk of pneumonia (95% CI:1.18-2.12; P=0.002) and peritonitis (100% CI:1.91-2.85; P<0.001), respectively, after adjusting for IPTW.
In addition, the competitive risk model demonstrated that differences in endpoints events between the 2 groups were still statistically significant (P=0.009, P<0.001, respectively) despite the presence of competition for other events (such as transfer to hemodialysis therapy, kidney transplant, transfer from their research center, loss to follow-up, and death). Clinicians are reminded to exercise caution when prescribing PPIs for PD patients because of the elevated risk of first pneumonia and PD-related peritonitis episodes.
Source: tandfonline.com/doi/full/10.1080/0886022X.2022.2129064
