{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:53:00Z","timestamp":1777564380304,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proton pump inhibitors (PPIs) have been commonly used for gastroesophageal reflux disease (GERD) and peptic ulcers (PU), which are even more prevalent in patients with chronic kidney disease (CKD). Although PPI\u2010related adverse outcomes are well documented in the general population, evidence in patients with CKD remains limited. This study investigated the associations of PPI use and adverse outcomes in patients with CKD who had GERD or PU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide, retrospective cohort study, patients with CKD and also PU or GERD from 2006 to 2015 were enrolled and sorted into no\u2010, short\u2010term, and long\u2010term PPI groups. Incidence and risks of outcome events between these three groups were analyzed with the Cochran\u2010Armitage test and Cox proportional hazard analyses. Events\u2010free probability was estimated with the Kaplan\u2013Meier method during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the study, 384,411 patients with CKD with PU or GERD were enrolled. The numbers of no\u2010, short\u2010term, and long\u2010term PPI treatments were 147,976, 14,153, and 3459, respectively. Relative to the no\u2010PPI group, the adjusted hazard ratios (aHRs) of admission for pneumonia and fracture, new diagnosis of type 2 diabetes mellitus (DM), and progression to end\u2010stage kidney disease (ESKD) in the short\u2010term (1.089, 1.083, 1.175, 1.22) and long\u2010term PPI groups (1.882, 2.601, 1.951, 1.714) remained statistically significant, respectively, even after adjustment for significant baseline variables; the aHR of dialysis was significant only in the long\u2010term PPI group. Kaplan\u2013Meier analysis revealed significant outcome events in the long\u2010term PPI group during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PPI use is associated with an increased risk of pneumonia, fracture, incidence of type 2 DM, and progression to ESKD in patients with CKD, and the risk increases substantially with increased duration of PPI use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70043","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:38:36Z","timestamp":1752835116000},"page":"512-521","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Pneumonia, Fracture, Metabolic, and Renal Events With Long\u2010Term Proton Pump Inhibitor Use in Patients With Chronic Kidney Disease"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2930-1862","authenticated-orcid":false,"given":"Yi\u2010Fan","family":"Chien","sequence":"first","affiliation":[{"name":"Division of General Medicine Cathay General Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5343-4887","authenticated-orcid":false,"given":"Yun\u2010Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Research Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4446-0167","authenticated-orcid":false,"given":"Chung\u2010Kuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Shin\u2010Kong Wu Ho\u2010Su Memorial Hospital  Taipei Taiwan"},{"name":"School of Medicine, Fu\u2010Jen Catholic University  New Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2016.0477"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000075308"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2022.2074535"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876\u2010022\u201002130\u20102"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442\u20102050.2009.01012.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aidm.2015.05.002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272\u2010013\u20100012\u2010x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468\u20101253(18)30037\u20102"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0016\u20105085(00)70004\u20107"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.563"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.01.031"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i19.2323"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010016\u20103510\u20101"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16091571"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15385"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102020\u2010322557"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.080873"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087952"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2010.84"},{"issue":"2","key":"e_1_2_9_21_1","first-page":"145","article-title":"Peptic Ulcer and Chronic Renal Failure","volume":"48","author":"Doherty C. 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