This study used the Japanese Adverse Drug Event Report database to investigate whether steroid use decreases the risk of nephropathy in patients who were administered a proton pump inhibitor (PPI). Disproportionality of kidney injury was observed between patients who did and those who did not use steroids while taking lansoprazole (reporting odds ratio, 0.78; 95% confidence interval [CI], 0.65-0.93; P = .002) or rabeprazole (reporting odds ratio, 0.69; 95%CI, 0.53-0.89; P = .005). Multiple logistic regression analysis revealed a significantly negative association of kidney injury with steroid use (odds ratio [OR], 0.85; 95%CI, 0.75-0.96; P = .011) and a significantly positive association with the presence of chronic kidney disease (OR, 1.66; 95%CI, 1.44-1.90; P < .001), the presence of comorbidities that relate to nephropathy (OR, 1.43; 95%CI, 1.29-1.59; P < .001), male sex (OR, 1.25; 95%CI, 1.13-1.39; P < .001), and age ≥80 years (OR, 1.21; 95%CI, 1.07-1.37; P = .002). These findings suggest that steroid use may decrease the risk of proton pump inhibitor-induced nephropathy.
Keywords: adverse event; nephropathy; proton pump inhibitor; steroid.
© 2021, The American College of Clinical Pharmacology.