title: Effect of low-dose proton pump inhibitor on preventing upper gastrointestinal bleeding in chronic kidney disease patients receiving aspirin.
abstract: OBJECTIVE
  Upper gastrointestinal bleeding (UGIB) leads to significant morbidity and mortality in chronic kidney disease (CKD) patients. This study determined the efficacy of using a low-dose proton pump inhibitor (PPI) to reduce the risk of non-variceal UGIB in CKD patients receiving aspirin.
  
  
  METHODS
  We retrospectively reviewed the medical records of 500 CKD patients who received aspirin between January 2008 and March 2013. Cumulative incidence analysis using the Kaplan-Meier method was performed to analyze the rate of non-variceal UGIB and association with the administration of low-dose PPI.
  
  
  RESULTS
  Of the 500 patients, 191 received low-dose PPI. Over the follow-up period, which lasted 1067 person-years, three patients in the low-dose PPI group (8.9 per 1000 person-years) and 19 patients in the non-PPI group (25.9 per 1000 person-years) developed non-variceal UGIB, respectively (P = 0.113). Low-dose PPI use did not decrease the risk of UGIB in CKD patients, including patients who did not receive dialysis (P = 0.127). However, according to the subgroup analysis of 230 patients who received dialysis, the low-dose PPI group (14.4 per 1000 person-years) demonstrated significantly reduced incidence and risk of non-variceal UGIB in comparison with the non-PPI group (53.8 per 1000 person-years) (P = 0.032).
  
  
  CONCLUSIONS
  Prophylactic low-dose PPI can reduce the risk of non-variceal UGIB in dialysis patients receiving aspirin.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Anyang, South Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Lim
authors.forename: Jong Hyeok
authors.initials: JH
authors.lastname: Kim
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.forename: Ho Suk
authors.initials: HS
authors.lastname: Kang
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Moon
authors.forename: Choong Kee
authors.initials: CK
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D003956:Dialysis; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012189:Retrospective Studies; D012306:Risk; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D001241:Aspirin
keywords: prophylaxis; proton pump inhibitors; upper gastrointestinal bleeding