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ASN: PPI Use May Up Risk for AKI After Cardiac Surgery

Adults receiving proton pump inhibitors have increased risk for acute kidney injury requiring dialysis following cardiac surgery

MONDAY, Nov. 15, 2021 (HealthDay News) — Preoperative proton pump inhibitor (PPI) use is associated with incident acute kidney injury (AKI) in patients undergoing cardiac surgery, according to a study presented at Kidney Week, the annual meeting of the American Society of Nephrology, held virtually from Nov. 4 to 7.

Hee Byung Koh, M.D., from Yonsei University in Seoul, South Korea, and colleagues used electronic medical records and nationwide health insurance information to identify two cohorts undergoing cardiac surgery. The Severance cardiac surgery cohort included 6,555 adults undergoing cardiac surgery between May 2011 and September 2020. The National Health Insurance Service-senior (NHIS-senior) cohort included 2,939 older patients (aged ≥60 years) who underwent cardiac surgery between 2004 and 2015.

The researchers found that after propensity score matching in the Severance cardiac surgery cohort, incident AKI-dialysis and in-hospital mortality were significantly higher among PPI-exposed versus PPI-unexposed patients. Furthermore, median hospital and intensive care unit stay durations were longer for patients exposed to PPIs versus those who were not. PPI exposure was significantly associated with incident AKI requiring dialysis (odds ratio, 2.20) and in-hospital mortality (odds ratio, 1.53). Similar findings were seen in the NHIS-senior cohort with PPI exposure significantly associated with incident AKI requiring dialysis (odds ratio, 2.29) and in-hospital mortality (odds ratio, 2.25).

“Our findings suggest that PPI exposure is a modifiable risk factor for cardiac surgery-associated AKI,” Koh said in a statement. “Stopping PPI before surgery may be a preventive strategy for AKI after cardiac surgery.”

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