Proton pump inhibitor (PPI) use may be an important and preventable source of fatigue and reduced health-related quality of life (HRQoL) in people who received renal transplants, a cross-sectional study shows. Previous studies have shown that PPIs “can adversely affect gut microbiota and uptake of micronutrients, particularly iron and magnesium,” the authors note. “Further studies examining the effect of PPI exposure in this population are warranted.”
Among recipients whose kidneys were transplanted more than 1 year earlier who were enrolled in the TransplantLines Biobank and Cohort Study, PPI use and occurrence of fatigue and HRQoL showed these patterns: “We included 937 kidney transplant recipients (mean age 56 ± 13 years, 39% female) at a median of 3 (1-10) years after transplantation. PPI use was associated with fatigue severity (regression coefficient 4.02, 95% CI, 2.18 to 5.85, P < 0.001), a higher risk of severe fatigue (OR 2.05, 95% CI, 1.48 to 2.84, P < 0.001), lower physical HRQoL (regression coefficient −8.54, 95% CI, −11.54 to −5.54, P < 0.001), and lower mental HRQoL (regression coefficient −4.66, 95% CI, −7.15 to −2.17, P < 0.001). These associations were independent of potential confounders including age, time since transplantation, history of upper gastrointestinal disease, antiplatelet therapy, and the total number of medications. They were present among all individually assessed PPI types and were dose dependent. Duration of PPI exposure was only associated with fatigue severity.”