Last month Knowridge Science Report warned its readers about the serious kidney damage that has been linked to proton pump inhibitors, or PPIs, used to treat heartburn, ulcers and acid reflux. The site reports that more than 15 million Americans are prescribed these drugs, which include the name brands Prevacid, Nexium and Prilosec. They are also available over-the-counter to countless more.
Knowridge references two recent studies. One published in February 2016 in the Journal of the American Medical Association by researchers at Johns Hopkins University compared PPIs to another common type of heartburn treatment, H2 receptor blockers such as ranitidine or Zantac, Pepcid and Tagamet. The researchers found that PPI use is an independent risk factor for chronic kidney disease and acute kidney injury, but H2 antagonist use is not.
The other study, published in April 2016 Journal of the American Society of Nephrology, was conducted by researchers at Washington University School of Medicine in St. Louis and Veterans Affairs St. Louis Health Care System. Using national VA databases they were able to identify and follow for five years 173,321 new users of PPIs and 20,270 new users of H2 receptor blockers.
The researchers found that the PPI users had a 28 percent increased risk of kidney damage compared to those taking H2 receptor blockers, and in addition to that they also found that they had a 98 percent increased risk of developing kidney failure. They noted that those who took PPIs for longer amounts of time were more likely to develop kidney issues.
Although the research doesn’t prove causation, the study authors say that these potential negative connections should be taken seriously considering the widespread use of PPIs. And they aren’t the only ones.
“This important study suggests that kidney damage may be far more common than anyone suspected. The large number of patients analyzed provides significant power to bolster the team’s conclusions,” said Benjamin Humphreys, MD, PhD, an associate professor and director of Washington University’s School of Medicine in St. Louis Division of Nephrology.
“The general assumption is that PPIs as a drug class are safe,” said Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University and the study’s senior author. “PPIs do not receive the same level of scrutiny as many other drugs in terms of indication for initiating treatment and duration of therapy.”
“We advise patients to limit the use of PPIs only to when they are medically necessary and for the shortest duration possible,” said Al-Aly, who also is the VA’s associate chief of staff for research and education and co-director of the Clinical Epidemiology Center.