Proton Pump Inhibitor Use Tied to Hip Fracture in Dialysis Patients

Correlation between PPI and hip fracture persisted for subgroups with low, medium, high PPI use.
Correlation between PPI and hip fracture persisted for subgroups with low, medium, high PPI use.

HealthDay News — Proton pump inhibitor (PPI) use is associated with increased risk of hip fracture among dialysis patients, according to a study published online September 27 in the Clinical Journal of the American Society of Nephrology.

Chandan Vangala, MD, from Baylor College of Medicine in Houston, and colleagues examined the impact of PPI use on hip fracture risk in a high-risk subset of patients with end-stage kidney disease requiring hemodialysis between 2009 and 2014. Eligible cases were matched with 10 controls on index date; data were included for 4,551 cases and 45,510 controls. PPI and histamine-2 receptor antagonist use were identified from Medicare Part D claims covering 3 years prior to the index date. 

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The researchers found that a larger proportion of cases than controls had prior PPI use (70 vs 63%) or histamine-2 receptor antagonist use (25 vs 23%). PPI use correlated with increased risk of hip fracture (adjusted odds ratio, 1.19). The correlation persisted in subgroups of low, moderate, and high PPI use, with adjusted odds ratios of 1.16, 1.21, and 1.19, respectively.

"Among patients with end-stage kidney disease on hemodialysis, PPIs, and not histamine-2 receptor antagonists, were associated with hip fracture events," the authors write.

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