首页> 外文期刊>Drug safety: An international journal of medical toxicology and drug experience >Long-term proton pump inhibitor use is associated with vascular calcification in chronic kidney disease: A cross-sectional study using propensity score analysis
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Long-term proton pump inhibitor use is associated with vascular calcification in chronic kidney disease: A cross-sectional study using propensity score analysis

机译:长期使用质子泵抑制剂与慢性肾脏疾病中的血管钙化有关:使用倾向评分分析的横断面研究

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Background: Proton pump inhibitors (PPIs) are a class of drugs that is extensively used for common gastrointestinal disorders and often prescribed long-term for years. Long-term PPI treatment is associated with an increased risk of fractures in the general population. Several studies have suggested a relationship between vascular calcification, which is a predictor of cardiovascular morbidity and mortality, impaired bone metabolism and fractures. In dialysis patients, vascular calcifications are widespread and are connected to bone health. Objective: The aim of this study was to assess the association between the use of PPIs and vascular calcifications involving the aorta and iliac arteries in haemodialysis patients. Methods: Between November 2008 and November 2009, 387 patients receiving long-term dialysis treatment (≥1 year) were enrolled in a multicentre (18 Dialysis Units), cross-sectional study. Overall, 76.2 % of patients were receiving long-term PPI treatment. The main outcome measure was calcification of the aorta and iliac arteries in relation to PPI use. Standardized radiographs were sent to the coordinating centre for centralized evaluation in duplicate by two physicians who were blind to PPI status. Results: Arterial calcifications were significantly more common in the PPI group (p < 0.01). Also, the rates of aortic and iliac calcifications considered separately were higher (+12.2 %, p = 0.0254; and +13.6 %, p = 0.0211, respectively). After correction for the propensity score, the odds ratios [ORs] (95 % CI) related to PPI use were aorta 1.89 (1.01-3.54), p = 0.048; iliac arteries 2.27 (1.31-3.92), p = 0.003; aorta and iliac arteries 2.59 (1.48-4.53), p = 0.008. The ORs (95 % CI) related to the association of warfarin + PPI were aorta 2.19 (0.95-5.00), p = 0.06; iliac arteries 2.90 (1.07-7.86), p = 0.036; aorta and iliac arteries 2.69 (1.03-6.96), p = 0.042. Conclusion: In haemodialysis patients, long-term treatment with PPIs, especially in the presence of warfarin treatment, is associated with vascular calcifications.
机译:背景:质子泵抑制剂(PPI)是一类药物,已广泛用于常见的胃肠道疾病,并且经常长期服用。长期的PPI治疗与普通人群骨折的风险增加有关。几项研究表明,血管钙化与心血管疾病的发病率和死亡率,骨代谢受损和骨折之间存在相关性。在透析患者中​​,血管钙化很普遍并且与骨骼健康有关。目的:本研究的目的是评估血液透析患者使用PPI与涉及主动脉和动脉的血管钙化之间的关系。方法:在2008年11月至2009年11月之间,对387名接受长期透析治疗(≥1年)的患者进行了多中心(18个透析单位)横断面研究。总体而言,有76.2%的患者正在接受长期PPI治疗。主要结果指标是与PPI使用相关的主动脉和动脉钙化。标准化的X射线照片由两名对PPI身份不知情的医生发送到协调中心进行一式两份的集中评估。结果:PPI组的动脉钙化明显更为常见(p <0.01)。同样,分别考虑的主动脉和骨钙化率也更高(分别为+ 12.2%,p = 0.0254;和+ 13.6%,p = 0.0211)。校正倾向得分后,与PPI使用相关的比值比[ORs](95%CI)为主动脉1.89(1.01-3.54),p = 0.048;动脉2.27(1.31-3.92),p = 0.003;主动脉和动脉2.59(1.48-4.53),p = 0.008。与华法令+ PPI关联相关的OR(95%CI)为主动脉2.19(0.95-5.00),p = 0.06;动脉2.90(1.07-7.86),p = 0.036;主动脉和动脉2.69(1.03-6.96),p = 0.042。结论:在血液透析患者中​​,长期使用PPI治疗,尤其是在使用华法林治疗的情况下,与血管钙化有关。

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