Overuse of acid suppressant drugs in patients with chronic renal failure.
BACKGROUND
Patients with chronic renal failure (CRF) have a high prevalence of gastrointestinal symptoms. The use of acid suppressive therapy (AST) in these patients is unexplored. We assessed the use of and indication for AST in CRF patients and compared them with hospitalized patients and patients with another chronic disease.


METHODS
A total of 293 patients with CRF were compared with 261 hospitalized patients and 181 patients with another chronic disease. Information about AST, endoscopic investigations and indication for therapy were obtained by medical records and patient interviews.


RESULTS
The use of AST was higher in CRF patients (41%, P<0.001) compared with hospitalized patients (13%) and patients with a chronic lung disease (18%), but similar in patients with a rheumatic disease (34%). Inadequate use of AST was high in CRF patients (63%) and hospitalized patients (81%), but lower in patients with another chronic disease (32%, P<0.01). Endoscopic investigations were performed in 41-46% of the patients. More than 90% of AST consisted of proton pump inhibitors (PPIs).


CONCLUSIONS
The majority of CRF patients had an inadequate indication for AST. Endoscopy seemed to be underused in these patients. PPIs were the dominating acid suppressive drug.
Strid
Hans
H
Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Göteborg, Sweden. hans@mbox342.swipnet.se
Simrén
Magnus
M
Björnsson
Einar S
ES
D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000008:administration & dosage* / Q000627:therapeutic use*; D002908:Chronic Disease; D004334:Drug Administration Schedule; D004363:Drug Utilization; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006635:Histamine H2 Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008171:Lung Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000008:administration & dosage / Q000627:therapeutic use*; D006435:Renal Dialysis; D012216:Rheumatic Diseases / Q000188:drug therapy*; D013997:Time Factors
D000863:Antacids; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D017494:Proton Pumps