What is the clinical evidence from this study?

Study design: Cohort. Population: Stage 3 or 4 chronic kidney disease (CKD) (n=30479). Intervention: Tegoprazan vs. Histamine-2 receptor antagonists (H2RAs) and Proton pump inhibitors (PPIs). Primary outcome: Composite of death or progression to end-stage kidney disease (ESKD) (HR 0.91, 95% CI 0.66-1.26, p=0.57).

What question did this study set out to answer?

To determine if tegoprazan increases the risk of death or progression to end-stage kidney disease in stage 3 or 4 CKD patients.

April 4, 2026Open Access

Tegoprazan and the risk of end-stage kidney disease progression: a nationwide Korean study

Resultado clave

Tegoprazan did not significantly increase the risk of death or end-stage kidney disease compared to H2RAs (HR 0.91) or PPIs (HR 0.87) in patients with stage 3 or 4 chronic kidney disease.

Puntos clave

To determine if tegoprazan increases the risk of death or progression to end-stage kidney disease in stage 3 or 4 CKD patients.
Analyzed data from a nationwide cohort of patients with stage 3 or 4 CKD
Included individuals with multiple risk factors for ESKD progression
Monitored outcomes over a minimum period of 90 days of tegoprazan use
No increase in risk of death among patients using tegoprazan
No significant difference in ESKD progression compared to those not using the medication
Findings suggest safety of tegoprazan in high-risk CKD populations

Diseño del estudio

Tipo

Cohort (n=30,479)

Multicéntrico

Sí

PICO estructurado

Does tegoprazan increase the risk of death or ESKD progression in adult patients with stage 3 or 4 CKD compared to PPIs or H2RAs?

Población

Adult patients with stage 3 or 4 chronic kidney disease (CKD) prescribed tegoprazan, proton pump inhibitors (PPIs), or histamine-2 receptor antagonists (H2RAs) for more than 90 days (n=30,479). Patients with a prior history of dialysis or kidney transplantation were excluded.

Intervención

Tegoprazan for a minimum of 90 days

Comparador

Proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) for a minimum of 90 days

Resultado

Composite of death or end-stage kidney disease (ESKD) within 3 years of the index datecomposite

In patients with stage 3 or 4 CKD, the use of tegoprazan for at least 90 days does not increase the risk of death or progression to ESKD compared to H2RAs or PPIs.

Resultado numérico

Estimación del efecto: HR 0.91 (95% CI 0.66-1.26)

Tasa de eventos absoluta: 11.7% vs 12.97%

valor p: p=0.57

Limitaciones

Retrospective design may introduce selection bias and unmeasured confounding factors.
True adherence to each acid-suppressive medication was not definitively confirmed.
Key clinical variables including lifestyle factors, laboratory measures, proteinuria severity, and blood pressure were not adjusted for.
Potential interactions between acid-suppressive medications and RAASi, SGLT2i, and GLP1RAs were not evaluated.
Relatively small CKD-tegoprazan cohort compared to the PPIs or H2RAs groups reduced statistical power.
Differences in race and ethnicity may limit the generalizability of these results to broader populations outside of South Korea.

Resumen

In patients with stage 3 or 4 CKD and multiple risk factors for ESKD progression, using tegoprazan for a minimum of 90 days did not increase the risk of death or ESKD progression.

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