Long-term kidney outcomes among users of proton pump inhibitors without intervening acute kidney injury Yan Xie, Benjamin Bowe, Tingting Li, Hong Xian,

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Long-term kidney outcomes among users of proton pump inhibitors without intervening acute kidney injury Yan Xie, Benjamin Bowe, Tingting Li, Hong Xian, Yan Yan, Ziyad Al-Aly Kidney International Volume 91, Issue 6, Pages 1482-1494 (June 2017) DOI: 10.1016/j.kint.2016.12.021 Copyright © 2017 Terms and Conditions

Figure 1 Survival probability for chronic kidney outcomes by the type of acid suppressant. (a) Incident estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. (b) Incident chronic kidney disease. (c) eGFR decrease >30%. (d) End-stage renal disease or eGFR decrease>50%. Kidney International 2017 91, 1482-1494DOI: (10.1016/j.kint.2016.12.021) Copyright © 2017 Terms and Conditions

Figure 2 Analytic strategies to examine the association of proton pump inhibitor use and risk of chronic renal outcomes without intervening acute kidney injury (AKI). CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease. Kidney International 2017 91, 1482-1494DOI: (10.1016/j.kint.2016.12.021) Copyright © 2017 Terms and Conditions

Figure 3 Mediation analyses of the association between proton pump inhibitor (PPI) use and chronic renal outcomes where acute kidney injury (AKI) was considered a mediator. Pathway a = a1 + a2 represents the pathway mediated by AKI. Pathway b represents the pathway not mediated by AKI. (a) Incident estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. (b) Incident chronic kidney disease (CKD). (c) eGFR decrease >30%. (d) End-stage renal disease (ESRD) or eGFR decrease >50%. Kidney International 2017 91, 1482-1494DOI: (10.1016/j.kint.2016.12.021) Copyright © 2017 Terms and Conditions

Figure 4 Cumulative duration of proton pump inhibitor (PPI) exposure and the risk of chronic renal outcomes. (a) Incident estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2. (b) Incident chronic kidney disease. (c) eGFR decrease >30%. (d) End-stage renal disease or eGFR decrease >50%. Kidney International 2017 91, 1482-1494DOI: (10.1016/j.kint.2016.12.021) Copyright © 2017 Terms and Conditions