Association of proton pump inhibitor use with risk of kidney stones: an analysis of cross-sectional data from the US National Health and Nutrition Examination Survey (2007-2018)

Objective Several studies have suggested a potential link between use of proton pump inhibitors (PPIs) and the risk of kidney stones, attributed to alterations in urine mineral levels. Our study aimed to investigate the association between PPI use and kidney stones in US adults.Design Cross-sectional study.Setting National Health and Nutrition Examination Survey (2007-2018).Participants 27 075 individuals with complete information on PPI use and history of kidney stones were included in this study.Outcomes and analyses Non-linear analysis, logistic regression analysis and subgroup analysis were conducted to estimate the relationship between PPI use and the occurrence and recurrence of kidney stones, after adjusting for potential confounding factors.Results Multivariable logistic regression analysis revealed a significant association between PPI use and kidney stones (OR 1.31, 95% CI 1.07 to 1.60), with a 4% increase in the prevalence of kidney stones for each additional year of PPI use (p<0.001). Similarly, PPI use was significantly associated with recurrent kidney stones (OR 1.49, 95% CI 1.04 to 2.13), with a 7% increase in the recurrence of kidney stones for each additional year of PPI use (p<0.001). Furthermore, these associations remained significant even after conducting propensity score matching analysis on a subset of PPI users and non-users (all p <= 0.001). Subgroup analyses showed that the effects of PPI use on kidney stones differed by age, sex, race and body mass index.Conclusions This study indicated that long-term use of PPI was associated with a higher risk of both the presence and recurrence of kidney stones.