Certain ulcer medications may increase risk of acute kidney injury after heart surgery

Acute kidney injury (AKI), an abrupt decline in kidney function, often arises after major surgeries. A recent analysis indicates that taking certain reflux and ulcer medications that reduce stomach acid may put patients at an elevated risk of developing AKI following cardiac surgery. The findings will be presented online at ASN Kidney Week 2021 November 4–November 7.

The study included medical information from 2 groups. The Severance cardiac surgery cohort consisted of 6,555 adults who underwent cardiac surgery between 2011 and 2020. The National Health Insurance Service-senior cohort included 2,939 older adults who underwent cardiac surgery between 2004 and 2015.

In the Severance cardiac surgery cohort, the rate of AKI requiring dialysis was 5.5% in those who used proton pump inhibitors (PPIs) and 3.2% in those who did not. In-hospital mortality rates were 4.7% and 3.2%, respectively. After adjustments, PPI use was linked with a 2.2-times higher odds of developing AKI requiring dialysis and a 1.53-times higher odds of dying during hospitalization. The other cohort revealed comparable findings, showing that PPI us was linked with a 2.29-times higher odds of AKI requiring dialysis and a 2.25-times higher odds of in-hospital mortality.

"Our findings suggest that PPI exposure is a modifiable risk factor for cardiac surgery–associated AKI," said lead author Hee Byung Koh, MD, of Yonsei University, in Seoul. "Stopping PPI before surgery may be a preventive strategy for AKI after cardiac surgery."