Houston, TX—Use of proton pump inhibitors (PPIs) is linked to a 19% greater risk of hip fracture in patients with kidney failure who are on dialysis, according to a new study. Similar effects were not seen with histamine-2 receptor antagonists, however, according to the report in the Clinical Journal of the American Society of Nephrology (CJASN).
Of the kidney-failure patients, nearly 75% of those sustaining hip fracture had been using the heartburn/acid reflux medications in the 3 years preceding the event, the Baylor College of Medicine–led researchers pointed out.
Patients with end-stage renal disease who are on hemodialysis already have a hip-fracture risk four times higher than that in the general population, the study noted; what has not been clear is how taking PPI medications affects the risk.
To help determine that, the Baylor researchers used information from the U.S. Renal Data System to identify all hip-fracture events recorded between 2009 and 2014 among hemodialysis-dependent patients—4,551—and matched each case with 10 patients on dialysis who did not experience hip fractures. Medicare Part D claims were used to gather prescription-drug information for the preceding 3 years.
Results indicated that a greater percentage of hip-fracture cases had any prior use of PPIs (70% versus 63%) or histamine-2 receptor antagonists (25% versus 23%).
The association between PPI use and hip fracture remained after analysis; low use of the drugs increased the risk by 16%; moderate use by 21%; and high use by 19%, the study team reported. Histamine-2 receptor antagonists were not associated with hip-fracture events, however.
“Proton pump inhibitors are the sixth most common type of medication prescribed among patients who are dependent on dialysis; however, their use is associated with increased hip fracture risk. Therefore, we recommend interval assessment of continued PPI use in hemodialysis-dependent patients, who already experience tremendous medication burden,” explained lead author Chandan Vangala, MD.
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Of the kidney-failure patients, nearly 75% of those sustaining hip fracture had been using the heartburn/acid reflux medications in the 3 years preceding the event, the Baylor College of Medicine–led researchers pointed out.
Patients with end-stage renal disease who are on hemodialysis already have a hip-fracture risk four times higher than that in the general population, the study noted; what has not been clear is how taking PPI medications affects the risk.
To help determine that, the Baylor researchers used information from the U.S. Renal Data System to identify all hip-fracture events recorded between 2009 and 2014 among hemodialysis-dependent patients—4,551—and matched each case with 10 patients on dialysis who did not experience hip fractures. Medicare Part D claims were used to gather prescription-drug information for the preceding 3 years.
Results indicated that a greater percentage of hip-fracture cases had any prior use of PPIs (70% versus 63%) or histamine-2 receptor antagonists (25% versus 23%).
The association between PPI use and hip fracture remained after analysis; low use of the drugs increased the risk by 16%; moderate use by 21%; and high use by 19%, the study team reported. Histamine-2 receptor antagonists were not associated with hip-fracture events, however.
“Proton pump inhibitors are the sixth most common type of medication prescribed among patients who are dependent on dialysis; however, their use is associated with increased hip fracture risk. Therefore, we recommend interval assessment of continued PPI use in hemodialysis-dependent patients, who already experience tremendous medication burden,” explained lead author Chandan Vangala, MD.
« Click here to return to Weekly News Update.
