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ORIGINAL ARTICLE
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Diabetic nephropathy and proton pump inhibitors – Pilot case-control study


1 Department of Pharmacology, St. John's Medical College, Sarjapur Road, Koramangala, Bengaluru, Karnataka, India
2 Final Year Medical Students, St. John's Medical College, Sarjapur Road, Koramangala, Bengaluru, Karnataka, India
3 Department of General Medicine, St. John's Medical College, Sarjapur Road, Koramangala, Bengaluru, Karnataka, India

Correspondence Address:
Shruthi M Kulkarni,
Department of General Medicine, St. John's Medical College, Sarjapur Road, Koramangala, Bengaluru, Karnataka – 560 034
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_397_20

Introduction: Proton pump inhibitors (PPIs) are liberally used over the counter medication and is largely considered safe. Off late, there are many reports that suggest increased incidence of chronic kidney disease with long-term PPI use. PPIs are often prescribed in patients with diabetes mellitus (DM) and one of the well-known complications of DM is diabetic nephropathy (DN). Thus, the aim of our study was to evaluate association between PPI use and DN. Methods: It was a case-control study conducted over a 2-year period (April 2017–March 2019). Cases were outpatients with type II DM and associated DN. Controls were age and sex-matched type II DM without DN. Results: A total of 200 participants, 100 each in the case and control group, were recruited. The proportion of participants using PPI was 62% in the cases and 42% in the controls (P = 0.005). The most common PPI used was pantoprazole. Increased duration of PPI use was significantly associated with DN [adjusted odds ratio: 1.171; 95% confidence interval: 1.022, 1.341; P = 0.023]. Conclusion: There is a significant association between the use of PPIs and DN in patients with type II DM. Since PPIs have other beneficial effects in patients with DM such as glycaemic control and relief from gastro-oesophageal symptoms, need for risk benefit assessment for long-term use of PPIs in DM is warranted.


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    -  Raj JP
    -  Pinto RW
    -  Tomy SK
    -  Kulkarni SM
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Indian Journal of Nephrology
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