Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients: Results From the TransplantLines Biobank and Cohort Study
Prior studies report that the use of proton pump inhibitors (PPIs) can adversely affect gut microbiota and gastrointestinal uptake of micronutrients, in particular iron and magnesium, and are used frequently by kidney transplant recipients. Altered gut microbiota, iron deficiency, and magnesium defi...
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| Veröffentlicht in: | American journal of kidney diseases 2023-08, Vol.82 (2), p.189-201.e1 |
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| creator | Knobbe, Tim J. Kremer, Daan Douwes, Rianne M. Eisenga, Michele F. Gomes-Neto, António W. Annema, Coby Swarte, J. Casper Klont, Frank Navis, Gerjan Berger, Stefan P. Bakker, Stephan J.L. Blokzijl, Hans Bodewes, Frank A.J.A. de Boer, Marieke T. Damman, Kevin de Borst, Martin H. Diepstra, Arjan Dijkstra, Gerard Doorenbos, Caecilia S.E. Erasmus, Michiel E. Gan, C. Tji Hak, Eelko Hepkema, Bouke G. Leuvenink, Henri G.D. Lexmond, Willem S. de Meijer, Vincent E. Niesters, Hubert G.M. van Pelt, L. Joost Pol, Robert A. Porte, Robert J. Ranchor, Adelta V. Sanders, Jan Stephan F. Siebelink, Marion J. Slart, Riemer J.H.J.A. Touw, Daan J. van den Heuvel, Marius C. van Leer-Buter, Coretta van Londen, Marco Verschuuren, Erik A.M. Vos, Michel J. Weersma, Rinse K. |
| description | Prior studies report that the use of proton pump inhibitors (PPIs) can adversely affect gut microbiota and gastrointestinal uptake of micronutrients, in particular iron and magnesium, and are used frequently by kidney transplant recipients. Altered gut microbiota, iron deficiency, and magnesium deficiency have been implicated in the pathogenesis of chronic fatigue. Therefore, we hypothesized that PPI use may be an important and underappreciated cause of fatigue and reduced health-related quality of life (HRQoL) in this population.
Cross-sectional study.
Kidney transplant recipients (≥1 year after transplantation) enrolled in the TransplantLines Biobank and Cohort Study.
PPI use, PPI type, PPI dosage, and duration of PPI use.
Fatigue and HRQoL, assessed using the validated Checklist Individual Strength 20 Revised questionnaire and Short Form-36 questionnaire.
Logistic and linear regression.
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 |
| doi_str_mv | 10.1053/j.ajkd.2022.12.012 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2778978200</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0272638623005322</els_id><sourcerecordid>2778978200</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3152-b73147ef4c4a9931feedea7fffd0ceb086193b61524120416573bd09ef8d4d6f3</originalsourceid><addsrcrecordid>eNp9kc9u1DAQhy0EokvhBTggHzmQ1H-yToK4wIqlFStRSnu2nHjMepvYwXaQ9nF4U7zdgnrqyXP45jee-RB6TUlJyZKf7Uq1u9UlI4yVlJWEsidoQZeMF6LhzVO0IKxmheCNOEEvYtwRQlouxHN0wkVDaMXpAv25DD55hy_nccIXbms7m3zANxHe4bVK9uecC-U0Pgc1pG1xBYNKoPH3WQ027bE3eGMNYOvwV6sd7PF1UC5Og3IJX0FvJwsuxfe5jvOQIl4HP-K0hQfcxjqI-JP1nXK3d8NWfutDwj_SrPcv0TOjhgiv7t9TdLP-fL06LzbfvlysPm6Knuedi67mtKrBVH2l2pZTA6BB1cYYTXroSCNoyzuR0YoyUlGxrHmnSQum0ZUWhp-it8fcKfhfM8QkRxt7GPIPwc9Rsrpu2rphhGSUHdE--BgDGDkFO6qwl5TIgxq5kwc18qBGUiazmtz05j5_7kbQ_1v-ucjAhyMAecvfFoKMfT5eD9oG6JPU3j6W_xc3caFe</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2778978200</pqid></control><display><type>article</type><title>Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients: Results From the TransplantLines Biobank and Cohort Study</title><source>Elsevier ScienceDirect Journals</source><creator>Knobbe, Tim J. ; Kremer, Daan ; Douwes, Rianne M. ; Eisenga, Michele F. ; Gomes-Neto, António W. ; Annema, Coby ; Swarte, J. Casper ; Klont, Frank ; Navis, Gerjan ; Berger, Stefan P. ; Bakker, Stephan J.L. ; Blokzijl, Hans ; Bodewes, Frank A.J.A. ; de Boer, Marieke T. ; Damman, Kevin ; de Borst, Martin H. ; Diepstra, Arjan ; Dijkstra, Gerard ; Doorenbos, Caecilia S.E. ; Erasmus, Michiel E. ; Gan, C. Tji ; Hak, Eelko ; Hepkema, Bouke G. ; Leuvenink, Henri G.D. ; Lexmond, Willem S. ; de Meijer, Vincent E. ; Niesters, Hubert G.M. ; van Pelt, L. Joost ; Pol, Robert A. ; Porte, Robert J. ; Ranchor, Adelta V. ; Sanders, Jan Stephan F. ; Siebelink, Marion J. ; Slart, Riemer J.H.J.A. ; Touw, Daan J. ; van den Heuvel, Marius C. ; van Leer-Buter, Coretta ; van Londen, Marco ; Verschuuren, Erik A.M. ; Vos, Michel J. ; Weersma, Rinse K.</creator><creatorcontrib>Knobbe, Tim J. ; Kremer, Daan ; Douwes, Rianne M. ; Eisenga, Michele F. ; Gomes-Neto, António W. ; Annema, Coby ; Swarte, J. Casper ; Klont, Frank ; Navis, Gerjan ; Berger, Stefan P. ; Bakker, Stephan J.L. ; Blokzijl, Hans ; Bodewes, Frank A.J.A. ; de Boer, Marieke T. ; Damman, Kevin ; de Borst, Martin H. ; Diepstra, Arjan ; Dijkstra, Gerard ; Doorenbos, Caecilia S.E. ; Erasmus, Michiel E. ; Gan, C. Tji ; Hak, Eelko ; Hepkema, Bouke G. ; Leuvenink, Henri G.D. ; Lexmond, Willem S. ; de Meijer, Vincent E. ; Niesters, Hubert G.M. ; van Pelt, L. Joost ; Pol, Robert A. ; Porte, Robert J. ; Ranchor, Adelta V. ; Sanders, Jan Stephan F. ; Siebelink, Marion J. ; Slart, Riemer J.H.J.A. ; Touw, Daan J. ; van den Heuvel, Marius C. ; van Leer-Buter, Coretta ; van Londen, Marco ; Verschuuren, Erik A.M. ; Vos, Michel J. ; Weersma, Rinse K. ; TransplantLines Investigators</creatorcontrib><description>Prior studies report that the use of proton pump inhibitors (PPIs) can adversely affect gut microbiota and gastrointestinal uptake of micronutrients, in particular iron and magnesium, and are used frequently by kidney transplant recipients. Altered gut microbiota, iron deficiency, and magnesium deficiency have been implicated in the pathogenesis of chronic fatigue. Therefore, we hypothesized that PPI use may be an important and underappreciated cause of fatigue and reduced health-related quality of life (HRQoL) in this population.
Cross-sectional study.
Kidney transplant recipients (≥1 year after transplantation) enrolled in the TransplantLines Biobank and Cohort Study.
PPI use, PPI type, PPI dosage, and duration of PPI use.
Fatigue and HRQoL, assessed using the validated Checklist Individual Strength 20 Revised questionnaire and Short Form-36 questionnaire.
Logistic and linear regression.
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.
Residual confounding and inability to assess causal relationships.
PPI use is independently associated with fatigue and lower HRQoL among kidney transplant recipients. PPI use might be an easily accessible target for alleviating fatigue and improving HRQoL among kidney transplant recipients. Further studies examining the effect of PPI exposure in this population are warranted.
In this observational study, we investigated the association of proton pump inhibitors with fatigue and health-related quality of life among kidney transplant recipients. Our data showed that proton pump inhibitors were independently associated with fatigue severity, severe fatigue, and lower physical and mental health-related quality of life. These associations were present among all individually assessed proton pump inhibitor types and were dose dependent. While we await future studies on this topic, proton pump inhibitor use might be an easily accessible target for alleviating fatigue and improving health-related quality of life among kidney transplant recipients.
[Display omitted]</description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2022.12.012</identifier><identifier>PMID: 36801431</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Gut-brain interaction ; kidney transplantation ; patient-reported outcome measures ; quality of life ; side effects ; tiredness</subject><ispartof>American journal of kidney diseases, 2023-08, Vol.82 (2), p.189-201.e1</ispartof><rights>2023 The Authors</rights><rights>Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3152-b73147ef4c4a9931feedea7fffd0ceb086193b61524120416573bd09ef8d4d6f3</citedby><cites>FETCH-LOGICAL-c3152-b73147ef4c4a9931feedea7fffd0ceb086193b61524120416573bd09ef8d4d6f3</cites><orcidid>0000-0003-3246-3192</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0272638623005322$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36801431$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knobbe, Tim J.</creatorcontrib><creatorcontrib>Kremer, Daan</creatorcontrib><creatorcontrib>Douwes, Rianne M.</creatorcontrib><creatorcontrib>Eisenga, Michele F.</creatorcontrib><creatorcontrib>Gomes-Neto, António W.</creatorcontrib><creatorcontrib>Annema, Coby</creatorcontrib><creatorcontrib>Swarte, J. Casper</creatorcontrib><creatorcontrib>Klont, Frank</creatorcontrib><creatorcontrib>Navis, Gerjan</creatorcontrib><creatorcontrib>Berger, Stefan P.</creatorcontrib><creatorcontrib>Bakker, Stephan J.L.</creatorcontrib><creatorcontrib>Blokzijl, Hans</creatorcontrib><creatorcontrib>Bodewes, Frank A.J.A.</creatorcontrib><creatorcontrib>de Boer, Marieke T.</creatorcontrib><creatorcontrib>Damman, Kevin</creatorcontrib><creatorcontrib>de Borst, Martin H.</creatorcontrib><creatorcontrib>Diepstra, Arjan</creatorcontrib><creatorcontrib>Dijkstra, Gerard</creatorcontrib><creatorcontrib>Doorenbos, Caecilia S.E.</creatorcontrib><creatorcontrib>Erasmus, Michiel E.</creatorcontrib><creatorcontrib>Gan, C. Tji</creatorcontrib><creatorcontrib>Hak, Eelko</creatorcontrib><creatorcontrib>Hepkema, Bouke G.</creatorcontrib><creatorcontrib>Leuvenink, Henri G.D.</creatorcontrib><creatorcontrib>Lexmond, Willem S.</creatorcontrib><creatorcontrib>de Meijer, Vincent E.</creatorcontrib><creatorcontrib>Niesters, Hubert G.M.</creatorcontrib><creatorcontrib>van Pelt, L. Joost</creatorcontrib><creatorcontrib>Pol, Robert A.</creatorcontrib><creatorcontrib>Porte, Robert J.</creatorcontrib><creatorcontrib>Ranchor, Adelta V.</creatorcontrib><creatorcontrib>Sanders, Jan Stephan F.</creatorcontrib><creatorcontrib>Siebelink, Marion J.</creatorcontrib><creatorcontrib>Slart, Riemer J.H.J.A.</creatorcontrib><creatorcontrib>Touw, Daan J.</creatorcontrib><creatorcontrib>van den Heuvel, Marius C.</creatorcontrib><creatorcontrib>van Leer-Buter, Coretta</creatorcontrib><creatorcontrib>van Londen, Marco</creatorcontrib><creatorcontrib>Verschuuren, Erik A.M.</creatorcontrib><creatorcontrib>Vos, Michel J.</creatorcontrib><creatorcontrib>Weersma, Rinse K.</creatorcontrib><creatorcontrib>TransplantLines Investigators</creatorcontrib><title>Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients: Results From the TransplantLines Biobank and Cohort Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Prior studies report that the use of proton pump inhibitors (PPIs) can adversely affect gut microbiota and gastrointestinal uptake of micronutrients, in particular iron and magnesium, and are used frequently by kidney transplant recipients. Altered gut microbiota, iron deficiency, and magnesium deficiency have been implicated in the pathogenesis of chronic fatigue. Therefore, we hypothesized that PPI use may be an important and underappreciated cause of fatigue and reduced health-related quality of life (HRQoL) in this population.
Cross-sectional study.
Kidney transplant recipients (≥1 year after transplantation) enrolled in the TransplantLines Biobank and Cohort Study.
PPI use, PPI type, PPI dosage, and duration of PPI use.
Fatigue and HRQoL, assessed using the validated Checklist Individual Strength 20 Revised questionnaire and Short Form-36 questionnaire.
Logistic and linear regression.
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.
Residual confounding and inability to assess causal relationships.
PPI use is independently associated with fatigue and lower HRQoL among kidney transplant recipients. PPI use might be an easily accessible target for alleviating fatigue and improving HRQoL among kidney transplant recipients. Further studies examining the effect of PPI exposure in this population are warranted.
In this observational study, we investigated the association of proton pump inhibitors with fatigue and health-related quality of life among kidney transplant recipients. Our data showed that proton pump inhibitors were independently associated with fatigue severity, severe fatigue, and lower physical and mental health-related quality of life. These associations were present among all individually assessed proton pump inhibitor types and were dose dependent. While we await future studies on this topic, proton pump inhibitor use might be an easily accessible target for alleviating fatigue and improving health-related quality of life among kidney transplant recipients.
[Display omitted]</description><subject>Gut-brain interaction</subject><subject>kidney transplantation</subject><subject>patient-reported outcome measures</subject><subject>quality of life</subject><subject>side effects</subject><subject>tiredness</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhy0EokvhBTggHzmQ1H-yToK4wIqlFStRSnu2nHjMepvYwXaQ9nF4U7zdgnrqyXP45jee-RB6TUlJyZKf7Uq1u9UlI4yVlJWEsidoQZeMF6LhzVO0IKxmheCNOEEvYtwRQlouxHN0wkVDaMXpAv25DD55hy_nccIXbms7m3zANxHe4bVK9uecC-U0Pgc1pG1xBYNKoPH3WQ027bE3eGMNYOvwV6sd7PF1UC5Og3IJX0FvJwsuxfe5jvOQIl4HP-K0hQfcxjqI-JP1nXK3d8NWfutDwj_SrPcv0TOjhgiv7t9TdLP-fL06LzbfvlysPm6Knuedi67mtKrBVH2l2pZTA6BB1cYYTXroSCNoyzuR0YoyUlGxrHmnSQum0ZUWhp-it8fcKfhfM8QkRxt7GPIPwc9Rsrpu2rphhGSUHdE--BgDGDkFO6qwl5TIgxq5kwc18qBGUiazmtz05j5_7kbQ_1v-ucjAhyMAecvfFoKMfT5eD9oG6JPU3j6W_xc3caFe</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Knobbe, Tim J.</creator><creator>Kremer, Daan</creator><creator>Douwes, Rianne M.</creator><creator>Eisenga, Michele F.</creator><creator>Gomes-Neto, António W.</creator><creator>Annema, Coby</creator><creator>Swarte, J. 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Casper</au><au>Klont, Frank</au><au>Navis, Gerjan</au><au>Berger, Stefan P.</au><au>Bakker, Stephan J.L.</au><au>Blokzijl, Hans</au><au>Bodewes, Frank A.J.A.</au><au>de Boer, Marieke T.</au><au>Damman, Kevin</au><au>de Borst, Martin H.</au><au>Diepstra, Arjan</au><au>Dijkstra, Gerard</au><au>Doorenbos, Caecilia S.E.</au><au>Erasmus, Michiel E.</au><au>Gan, C. Tji</au><au>Hak, Eelko</au><au>Hepkema, Bouke G.</au><au>Leuvenink, Henri G.D.</au><au>Lexmond, Willem S.</au><au>de Meijer, Vincent E.</au><au>Niesters, Hubert G.M.</au><au>van Pelt, L. Joost</au><au>Pol, Robert A.</au><au>Porte, Robert J.</au><au>Ranchor, Adelta V.</au><au>Sanders, Jan Stephan F.</au><au>Siebelink, Marion J.</au><au>Slart, Riemer J.H.J.A.</au><au>Touw, Daan J.</au><au>van den Heuvel, Marius C.</au><au>van Leer-Buter, Coretta</au><au>van Londen, Marco</au><au>Verschuuren, Erik A.M.</au><au>Vos, Michel J.</au><au>Weersma, Rinse K.</au><aucorp>TransplantLines Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients: Results From the TransplantLines Biobank and Cohort Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2023-08</date><risdate>2023</risdate><volume>82</volume><issue>2</issue><spage>189</spage><epage>201.e1</epage><pages>189-201.e1</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Prior studies report that the use of proton pump inhibitors (PPIs) can adversely affect gut microbiota and gastrointestinal uptake of micronutrients, in particular iron and magnesium, and are used frequently by kidney transplant recipients. Altered gut microbiota, iron deficiency, and magnesium deficiency have been implicated in the pathogenesis of chronic fatigue. Therefore, we hypothesized that PPI use may be an important and underappreciated cause of fatigue and reduced health-related quality of life (HRQoL) in this population.
Cross-sectional study.
Kidney transplant recipients (≥1 year after transplantation) enrolled in the TransplantLines Biobank and Cohort Study.
PPI use, PPI type, PPI dosage, and duration of PPI use.
Fatigue and HRQoL, assessed using the validated Checklist Individual Strength 20 Revised questionnaire and Short Form-36 questionnaire.
Logistic and linear regression.
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.
Residual confounding and inability to assess causal relationships.
PPI use is independently associated with fatigue and lower HRQoL among kidney transplant recipients. PPI use might be an easily accessible target for alleviating fatigue and improving HRQoL among kidney transplant recipients. Further studies examining the effect of PPI exposure in this population are warranted.
In this observational study, we investigated the association of proton pump inhibitors with fatigue and health-related quality of life among kidney transplant recipients. Our data showed that proton pump inhibitors were independently associated with fatigue severity, severe fatigue, and lower physical and mental health-related quality of life. These associations were present among all individually assessed proton pump inhibitor types and were dose dependent. While we await future studies on this topic, proton pump inhibitor use might be an easily accessible target for alleviating fatigue and improving health-related quality of life among kidney transplant recipients.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36801431</pmid><doi>10.1053/j.ajkd.2022.12.012</doi><orcidid>https://orcid.org/0000-0003-3246-3192</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2023-08, Vol.82 (2), p.189-201.e1 |
| issn | 0272-6386 1523-6838 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2778978200 |
| source | Elsevier ScienceDirect Journals |
| subjects | Gut-brain interaction kidney transplantation patient-reported outcome measures quality of life side effects tiredness |
| title | Proton Pump Inhibitor Use, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients: Results From the TransplantLines Biobank and Cohort Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T04%3A49%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Proton%20Pump%20Inhibitor%20Use,%20Fatigue,%20and%20Health-Related%20Quality%20of%20Life%20in%20Kidney%20Transplant%20Recipients:%20Results%20From%20the%20TransplantLines%20Biobank%20and%20Cohort%20Study&rft.jtitle=American%20journal%20of%20kidney%20diseases&rft.au=Knobbe,%20Tim%20J.&rft.aucorp=TransplantLines%20Investigators&rft.date=2023-08&rft.volume=82&rft.issue=2&rft.spage=189&rft.epage=201.e1&rft.pages=189-201.e1&rft.issn=0272-6386&rft.eissn=1523-6838&rft_id=info:doi/10.1053/j.ajkd.2022.12.012&rft_dat=%3Cproquest_cross%3E2778978200%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2778978200&rft_id=info:pmid/36801431&rft_els_id=S0272638623005322&rfr_iscdi=true |