Association between Urolithiasis and History Proton Pump Inhibitor Medication: A Nested Case-Control Study

Area of Science:

• Gastroenterology and Nephrology
• Pharmacoepidemiology

Background:

• Retrospective studies suggest a link between proton pump inhibitors (PPIs) and urolithiasis.
• The precise risk and dose-response relationship require further investigation.

Purpose of the Study:

• To estimate the risk of urolithiasis associated with previous proton pump inhibitor (PPI) use.
• To evaluate the dose-response relationship between PPI duration and urolithiasis risk.

Main Methods:

• Nested case-control study utilizing the Korean National Health Insurance Service-National Health Screening Cohort.
• Inclusion of 28,962 urolithiasis cases and 115,848 controls.
• Analysis of PPI prescription history and duration using logistic regression models.

Main Results:

• Current PPI users had significantly higher odds of urolithiasis (OR = 2.49).
• A dose-response association was observed, with longer PPI use correlating to increased urolithiasis risk.
• Subgroup analyses consistently supported a positive association between prior PPI use and urolithiasis.

Conclusions:

• Prior proton pump inhibitor (PPI) use is associated with an elevated risk of urolithiasis.
• The risk of urolithiasis increases with the duration of PPI use, indicating a dose-response effect.