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Retrospective cohort study links PPI use to drug-related problems in hospitalized renal disease patientsNearly half of hospitalized kidney patients had drug problems linked to stomach acid reducers

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Key Takeaway
Note that anti-infective drugs and antiplatelet agents are independently associated with inappropriate PPI use in renal inpatients.

This retrospective cohort study examined 520 hospitalized internal nephrology inpatients with renal disease to evaluate drug-related problems (DRPs) associated with proton pump inhibitors (PPIs). The primary outcome measured the proportion of patients experiencing DRPs, while secondary outcomes analyzed factors contributing to inappropriate PPI use. No specific adverse events or discontinuations were reported in the safety data.

A total of 303 DRPs were identified among the 520 patients. The proportion of patients experiencing DRPs was 46.34%, corresponding to 241 patients. Multivariate analysis revealed independent associations between the purpose of PPI application and inappropriate PPI use, with an odds ratio of 0.455 (95% CI 0.305–0.680, p < 0.001). This association was protective.

Conversely, concurrent use of antiplatelet agents was independently associated with inappropriate PPI use, with an odds ratio of 1.552 (95% CI 1.062–2.268, p = 0.023). Similarly, anti-infective drugs showed an independent association with inappropriate PPI use, with an odds ratio of 1.922 (95% CI 1.313–2.813, p = 0.001). Peritoneal dialysis was also independently associated with inappropriate PPI use, with an odds ratio of 1.743 (95% CI 1.028–2.955, p = 0.039). These associations were derived from multivariate analysis.

The study notes that systematic identification of PPI-related DRPs and analysis of their determinants by clinical pharmacists will substantially promote the rational use of PPIs in hospitalized patients with renal disease. The retrospective design limits causal inference regarding these associations.

Nearly half of hospitalized kidney patients faced drug problems linked to stomach acid reducers. This study looked at 520 people in a hospital setting. It found that 241 patients experienced these issues. That is a rate of 46.34 percent. These problems are called drug-related problems. They can happen when medicines do not work well or cause unwanted effects.

The research also looked at what made these issues more likely. Taking anti-infective drugs was a strong risk factor. It increased the odds of a drug problem by 92 percent. Using antiplatelet agents also raised the risk by 55 percent. Patients on peritoneal dialysis faced higher risks as well. The purpose of taking the stomach acid reducer mattered too. When the drug was used for reasons that were not appropriate, problems were more likely to occur.

The study team noted that identifying these issues helps doctors use medicines more wisely. Clinical pharmacists can play a big role in spotting these problems. They can help ensure patients get the right treatment without unnecessary risks. This work supports better care for people with kidney disease who are in the hospital.

What this means for you:
Nearly half of hospitalized kidney patients had drug problems linked to stomach acid reducers.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
AimsTo identify drug-related problems (DRPs) associated with proton pump inhibitors (PPIs) and their influencing factors among hospitalized nephrology patients, thereby providing evidence for the rational use of PPIs.MethodsA retrospective cohort of internal nephrology inpatients who received PPIs between June 2024 and May 2025 was assembled. Clinical pharmacists applied the PCNE classification system (version 9.1) to identify and categorize PPI-related DRPs. Univariate and multivariate logistic regression analyses were performed to explore factors contributing to inappropriate PPIs use.ResultsA total of 520 patients were included, of which 241 patients (46.34%) experienced 303 DRPs. The most frequent problems involved drug selection and treatment duration. Multivariate analysis revealed that the following variables were independently associated with inappropriate PPIs use: purpose of PPI application (OR = 0.455, 95% CI 0.305–0.680, p < 0.001), antiplatelet agents (OR = 1.552, 95% CI 1.062–2.268, p = 0.023), anti-infective drugs (OR = 1.922, 95% CI 1.313–2.813, p = 0.001), and peritoneal dialysis (OR = 1.743, 95% CI 1.028–2.955, p = 0.039).ConclusionSystematic identification of PPI-related DRPs and analysis of their determinants by clinical pharmacists will substantially promote the rational use of PPIs in hospitalized patients with renal disease.
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