Proton Pump Inhibitor Prevalence and Documented Indication in a Small Kidney Transplant Program
Bibliographic record
Abstract
Background: Proton pump inhibitors (PPIs) are commonly prescribed post kidney transplantation, and their use was prevalent in 44-48% of recipients. Prolonged exposure to PPIs could be associated with renal and non-renal adverse outcomes, including hypomagnesemia and hip fracture (OR: 1.39, 95% CI: 1.04-1.84). The objective of this report is to evaluate the prevalence and the documented indication of PPI use in our kidney transplant program, while exploring the potential PPI withdrawal and GERD recurrence in a future Quality Improvement (QI) project. Methods: This is a retrospective study to assess the prevalence and the documented indications of PPI use among all of kidney transplant recipients in our program by March 31st, 2020. The primary variables were the prevalence of PPI use and the percentage of patients with documented indication of PPI use in our Health Information System (HIS). Results: Out of 202 kidney transplant recipients, 113 (55.9%) patients were on PPIs (Mean age 58 years, Male 68 (60.2%), mean post-transplant longevity 106 months), compared with 12 (5.9%) patients on H2 blockers. Thirty three (29.2%) patients who used to be on H2 blockers were switched to PPI in late 2019 due to contaminated and backordered ranitidine resulting in an adjusted prevalence of PPI use of 39.5% (Figure 1). The indication of PPI use was documented in our HIS as gastro-esophageal reflux disease (GERD) in 53 (46.9%) patients, and as peptic ulcer disease (PUD) in 9 (8%) patients, while its indication was undocumented in 51 (45.1%) patients. Conclusions: PPI use was prevalent among our kidney transplant recipients similar to other studies. Due to its association with multiple adverse outcomes, better documentation of its indication in the medical record is required. Consideration to withdraw PPI in our kidney transplant recipients and to reassess the risk of GERD recurrence will be assessed in a future QI project.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".