Use of proton pump inhibitors in dialysis unit in tertiary care hospital: a pharmaco-epidemiological study

Shabbir R. Pendhari, K. Joshi, R. Limaye
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Abstract

Background: Proton pump inhibitors (PPI) are generally thought to be safer drug with fewer adverse effects. Though this class of the drug is thought to be well tolerated, a detail study about actual use of these agents in nephrology department is still awaited in many parts of India. There had been case reports and case series which were reporting PPIs producing acute interstitial nephritis progressing to acute renal failure. The risk of PPI treatment in haemodialysis patients remains unexplored. The aim of the study was to evaluate a drug utilization of PPI in patient undergoing haemodialysis procedure. Methods: In this study every day visit to the dialysis units of the hospitals was carried out. After taking consent from the patients, the information from the case-report form was noted like; age, sex, diagnosis, laboratory reports and drug prescried. No personally identifiable information about patient or physician was collected. After this an interview of patients was taken. Results: In this study, out of 126 patients 76.6% were male and 23.4% were female. Out of these 126 patients 88.89% patients were on PPI. Nearly 54% were using PPI for more than six months. Nearly 29% patients were using PPI for more than 12 months. Conclusions: As many case-reports and studies are suggesting, there is co-relation of PPI and acute interstitial nephritis from this study we suggest that especially in nephrology unit patients’, more caution must be exercised while using PPI.
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质子泵抑制剂在三级医院透析单元的应用:一项药物流行病学研究
背景:质子泵抑制剂(PPI)通常被认为是一种更安全、副作用更小的药物。尽管这类药物被认为耐受性良好,但在印度许多地区,这些药物在肾脏病科的实际使用情况仍有待详细研究。有病例报告和病例系列报道PPIs导致急性间质性肾炎进展为急性肾功能衰竭。血液透析患者使用PPI治疗的风险尚不清楚。本研究的目的是评价血液透析患者使用PPI的情况。方法:在本研究中,对医院透析单元进行每日访视。在征得患者同意后,病例报告表上的信息如下:年龄、性别、诊断、实验室报告和处方药物。没有收集患者或医生的个人身份信息。在此之后,对病人进行了采访。结果:126例患者中男性占76.6%,女性占23.4%。在这126例患者中,88.89%的患者使用PPI。近54%的人使用PPI超过6个月。近29%的患者使用PPI超过12个月。结论:正如许多病例报告和研究所提示的,本研究显示PPI与急性间质性肾炎存在相关性。我们建议,特别是肾病科患者在使用PPI时应更加谨慎。
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