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Proton Pump Inhibitors and Kidney Disease: Fact or Fiction?

BACKGROUND: Proton pump inhibitors (PPI) are commonly prescribed medications for dyspepsia and gastroesophageal reflux. There are concerns about their use in the development of chronic kidney disease (CKD).

SUMMARY: The available published literature fails to support an association with PPI and the development of CKD. Placebo-controlled trials demonstrate no difference on the incidence of CKD between placebo and PPI. If one examines the data according to the Bradford Hill perspective incorporating temporal relationship, strength of association, dose response relationship, replacement of findings, cessation of exposure, specificity of the association and consistency with other knowledge, one can only conclude that there is no consistent relationship between PPI use and the development of CKD, or its progression.

KEY MESSAGES: There is insufficient evidence to link PPI exposure with the development or progression of CKD.

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