{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:59:14Z","timestamp":1790330354632,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Korea Health Technology R&D Project"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health & Welfare"},{"name":"Republic of Korea","award":["RS-2024-00439231"],"award-info":[{"award-number":["RS-2024-00439231"]}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Research Center Program","award":["RS-2024-00409403"],"award-info":[{"award-number":["RS-2024-00409403"]}]},{"DOI":"10.13039\/501100014188","name":"MSIT","doi-asserted-by":"publisher","award":["RS-2024-00343323"],"award-info":[{"award-number":["RS-2024-00343323"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and hypothesis<\/jats:title>\n                    <jats:p>Proton pump inhibitors (PPIs) are widely used for acid suppression but have been associated with kidney injury. Potassium-competitive acid blockers such as tegoprazan provide rapid, reversible inhibition of gastric H\u207a\/K\u207a-ATPase, yet their renal safety remains unclear. We compared the risk of incident chronic kidney disease (CKD) between tegoprazan and PPIs in a nationwide population-based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Korean Health Insurance Review and Assessment database, we identified adults without prior kidney disease who initiated tegoprazan or a PPI during 2020\u20132021. After 1:3 propensity score matching, we compared the risk of incident CKD using Cox proportional hazards models. Sensitivity and subgroup analyses examined robustness and effect modification by age, sex, and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 901\u2009606 new users (43\u2009864 tegoprazan; 857\u2009742 PPIs), PPI use was associated with a higher CKD incidence (6.16\u00a0vs. 4.63 per 1000 person-years). In the matched cohort, PPI initiation was associated with a higher risk of CKD than tegoprazan initiation [hazard ratio (HR) 1.22; 95% confidence interval (CI), 1.09\u20131.37; P\u00a0&amp;lt;\u00a0.01]. Findings were consistent across subgroups and sensitivity analyses, including the unmatched cohort (HR, 1.34; 95% CI, 1.20\u20131.48; P\u00a0&amp;lt;\u00a0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large real-world analysis, PPI initiation was associated with a higher rate of newly coded CKD than tegoprazan initiation. These findings provide comparative kidney safety data and suggest that risk of kidney injury may be one consideration, alongside efficacy and cost, when prolonged acid suppression is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfag206","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:34:44Z","timestamp":1788521684000},"source":"Crossref","is-referenced-by-count":0,"title":["CKD risk with tegoprazan versus proton pump inhibitors"],"prefix":"10.1093","author":[{"given":"Su Young","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Sic","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Data Mining and Computational Biology, Department of Convergence Medicine, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]},{"name":"Department of Nephrology, Comprehensive Kidney Disease Research Institute, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangwon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Comprehensive Kidney Disease Research Institute, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]},{"name":"Department of Precision Medicine, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8047-4190","authenticated-orcid":false,"given":"Jun Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Comprehensive Kidney Disease Research Institute, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]},{"name":"Mitohormesis Research Center, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]},{"name":"Institute of Evidence Based Medicine, Yonsei University Wonju College of Medicine , Wonju ,","place":["South Korea"]},{"name":"National Health Big Data Clinical Research Institute, Wonju College of Medicine , Wonju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2026092505020993000_bib1","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1038\/nrgastro.2017.117","article-title":"Proton-pump inhibitors: understanding the complications and risks","volume":"14","author":"Malfertheiner","year":"2017","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2026092505020993000_bib2","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1001\/jamainternmed.2015.7193","article-title":"Proton pump inhibitor use and the risk of chronic kidney disease","volume":"176","author":"Lazarus","year":"2016","journal-title":"JAMA Intern Med"},{"key":"2026092505020993000_bib3","doi-asserted-by":"publisher","first-page":"3153","DOI":"10.1681\/ASN.2015121377","article-title":"Proton pump inhibitors and risk of incident CKD and progression to ESRD","volume":"27","author":"Xie","year":"2016","journal-title":"J Am Soc Nephrol"},{"key":"2026092505020993000_bib4","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1016\/j.kint.2016.12.021","article-title":"Long-term kidney outcomes among users of proton pump inhibitors without intervening acute kidney injury","volume":"91","author":"Xie","year":"2017","journal-title":"Kidney Int"},{"key":"2026092505020993000_bib5","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1053\/j.gastro.2017.05.046","article-title":"Association between proton pump inhibitor use and risk of progression of chronic kidney disease","volume":"153","author":"Klatte","year":"2017","journal-title":"Gastroenterology"},{"key":"2026092505020993000_bib6","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1136\/bmj.39406.449456.BE","article-title":"Overprescribing proton pump inhibitors","volume":"336","author":"Forgacs","year":"2008","journal-title":"BMJ"},{"key":"2026092505020993000_bib7","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1093\/qjmed\/hcn035","article-title":"Overuse and inappropriate prescribing of proton pump inhibitors in patients with Clostridium difficile-associated disease","volume":"101","author":"Choudhry","year":"2008","journal-title":"QJM"},{"key":"2026092505020993000_bib8","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1111\/apt.15185","article-title":"Randomised phase 3 trial: tegoprazan, a novel potassium-competitive acid blocker, vs. esomeprazole in patients with erosive oesophagitis","volume":"49","author":"Lee","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"2026092505020993000_bib9","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1124\/jpet.117.244202","article-title":"Tegoprazan, a novel potassium-competitive acid blocker to control gastric acid secretion and motility","volume":"364","author":"Takahashi","year":"2018","journal-title":"J Pharmacol Exp Ther"},{"key":"2026092505020993000_bib10","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1053\/j.ajkd.2019.07.012","article-title":"Proton pump inhibitors and the kidney: implications of current evidence for clinical practice and when and how to deprescribe","volume":"75","author":"Al-Aly","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"2026092505020993000_bib11","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1016\/j.kint.2022.06.007","article-title":"Vonoprazan-associated nephrotoxicity: extensive real-world evidence from spontaneous adverse drug reaction reports","volume":"102","author":"Ishida","year":"2022","journal-title":"Kidney Int"},{"key":"2026092505020993000_bib12","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1002\/cpt.3183","article-title":"Relationships of proton pump inhibitor-induced renal injury with CYP2C19 polymorphism: a retrospective cohort study","volume":"115","author":"Fukui","year":"2024","journal-title":"Clin Pharma Ther"},{"key":"2026092505020993000_bib13","doi-asserted-by":"publisher","first-page":"493","DOI":"10.5009\/gnl220272","article-title":"Role of tegoprazan in Helicobacter pylori eradication therapy","volume":"16","author":"Lee","year":"2022","journal-title":"Gut Liver"},{"key":"2026092505020993000_bib14","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1111\/apt.15865","article-title":"Randomised clinical trial: tegoprazan, a novel potassium-competitive acid blocker, or lansoprazole in the treatment of gastric ulcer","volume":"52","author":"Cho","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"2026092505020993000_bib15","doi-asserted-by":"publisher","first-page":"e2014008","DOI":"10.4178\/epih\/e2014008","article-title":"A guide for the utilization of health insurance review and assessment service national patient samples","volume":"36","author":"Kim","year":"2014","journal-title":"Epidemiol Health"},{"key":"2026092505020993000_bib16","doi-asserted-by":"publisher","first-page":"e45","DOI":"10.1097\/EDE.0000000000000864","article-title":"Web site and R package for computing E-values","volume":"29","author":"Mathur","year":"2018","journal-title":"Epidemiology"},{"key":"2026092505020993000_bib17","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes CKDWG","year":"2024","journal-title":"Kidney Int"},{"key":"2026092505020993000_bib18","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1111\/j.1365-2125.2007.02927.x","article-title":"Proton pump inhibitor-induced acute interstitial nephritis","volume":"64","author":"H\u00e4rmark","year":"2007","journal-title":"Br J Clin Pharma"},{"key":"2026092505020993000_bib19","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1038\/ki.2010.89","article-title":"Acute interstitial nephritis","volume":"77","author":"Praga","year":"2010","journal-title":"Kidney Int"},{"key":"2026092505020993000_bib20","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1053\/j.ajkd.2015.05.012","article-title":"Proton pump inhibitors and hypomagnesemia in the general population: a population-based cohort study","volume":"66","author":"Kieboom","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"2026092505020993000_bib21","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1038\/ki.2012.452","article-title":"Proton-pump inhibitor use is associated with low serum magnesium concentrations","volume":"83","author":"Danziger","year":"2013","journal-title":"Kidney Int"},{"key":"2026092505020993000_bib22","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1038\/ki.2014.331","article-title":"Results from the Atherosclerosis Risk in Communities study suggest that low serum magnesium is associated with incident kidney disease","volume":"87","author":"Tin","year":"2015","journal-title":"Kidney Int"},{"key":"2026092505020993000_bib23","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1021\/tx5003782","article-title":"Systematic toxicity mechanism analysis of proton pump inhibitors: an in silico study","volume":"28","author":"Wu","year":"2015","journal-title":"Chem Res Toxicol"},{"key":"2026092505020993000_bib24","doi-asserted-by":"publisher","first-page":"e36","DOI":"10.1161\/CIRCRESAHA.116.308807","article-title":"Proton pump inhibitors accelerate endothelial senescence","volume":"118","author":"Yepuri","year":"2016","journal-title":"Circ Res"},{"key":"2026092505020993000_bib25","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1111\/j.1365-2125.2010.03717.x","article-title":"Influences of different proton pump inhibitors on the anti-platelet function of clopidogrel in relation to CYP2C19 genotypes","volume":"70","author":"Furuta","year":"2010","journal-title":"Br J Clin Pharmacol"},{"key":"2026092505020993000_bib26","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1007\/s40262-023-01228-4","article-title":"Evaluation of CYP2C19-mediated pharmacokinetic drug interaction of tegoprazan, compared with vonoprazan or esomeprazole","volume":"62","author":"Yang","year":"2023","journal-title":"Clin Pharmacokinet"},{"key":"2026092505020993000_bib27","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003943","article-title":"Proton pump inhibitors are more cost-effective than potassium competitive acid blockers for gastroesophageal reflux disease","author":"Karlin","year":"2026","journal-title":"Am J Gastroenterol"},{"key":"2026092505020993000_bib28","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1053\/j.gastro.2024.06.038","article-title":"AGA clinical practice update on integrating potassium-competitive acid blockers into clinical practice: expert review","volume":"167","author":"Patel","year":"2024","journal-title":"Gastroenterology"},{"key":"2026092505020993000_bib29","doi-asserted-by":"publisher","first-page":"382","DOI":"10.23876\/j.krcp.18.0128","article-title":"Impact of chronic kidney disease on mortality: a nationwide cohort study","volume":"38","author":"Kim","year":"2019","journal-title":"Kidney Res Clin Pr"},{"key":"2026092505020993000_bib30","doi-asserted-by":"publisher","first-page":"552","DOI":"10.4093\/dmj.2022.0193","article-title":"Current trends of big data research using the Korean National Health Information Database","volume":"46","author":"Kim","year":"2022","journal-title":"Diabetes Metab J"},{"key":"2026092505020993000_bib31","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1053\/j.ajkd.2010.08.031","article-title":"Validity of administrative database coding for kidney disease: a systematic review","volume":"57","author":"Vlasschaert","year":"2011","journal-title":"Am J Kidney Dis"},{"key":"2026092505020993000_bib32","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1093\/ndt\/gfr598","article-title":"Validating a case definition for chronic kidney disease using administrative data","volume":"27","author":"Ronksley","year":"2012","journal-title":"Nephrol Dial Transpl"},{"key":"2026092505020993000_bib33","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1002\/pds.5398","article-title":"Accuracy of identifying diagnosis of moderate to severe chronic kidney disease in administrative claims data","volume":"31","author":"Paik","year":"2022","journal-title":"Pharmacoepidemiol Drug"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag206\/70963349\/gfag206.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag206\/70963349\/gfag206.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:02:16Z","timestamp":1790326936000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article\/doi\/10.1093\/ndt\/gfag206\/8785788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":33,"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfag206","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"article-number":"gfag206"}}