Kidney damage related to PPIs can be easy to miss, warn authors of new study

PPI proton pump inhibitor Kidney damage related to PPIs can be easy to miss, warn authors of new studyA new study published this February in Kidney International found that kidney damage linked to acid reflux drugs known as proton pump inhibitors, or PPIs, might be going unnoticed. More than half of the PPI users who developed kidney damage did not experience the typical acute kidney problems beforehand, which generally serve as a warning to doctors that there has been decline in kidney function.

“Our results indicate kidney problems can develop silently and gradually over time, eroding kidney function and leading to long-term kidney damage or even renal failure. Patients should be cautioned to tell their doctors if they’re taking PPIs and only use the drugs when necessary,” Ziyad Al-Aly, MD, the study’s senior author and an assistant professor of medicine at Washington University School of Medicine, said, according to Science Daily.

The researchers from Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System conducted a big data study from the Department of Veterans Affairs databases analyzing more than five years of follow-up data on more than 125,000 users of PPIs and more than 18,000 users of an alternate acid-reducing drug, H2 blockers. According to CBS News, the study showed that with continued use of the PPIs the rate of chronic kidney disease went up, confirming the findings of several similar studies published last year.

Of extreme interest in this study was the finding that 80 percent of PPI users did not develop acute kidney problems. This did not mean, however, that the PPI users were not being diagnosed with chronic kidney disease and end-stage renal disease. More than half of those diagnoses occurred in people who did not experience acute kidney problems.

“Doctors must pay careful attention to kidney function in their patients who use PPIs, even when there are no signs of problems,” cautioned Al-Aly according to Nephrology News. Al-Aly also is the VA’s associate chief of staff for research and education and co-director of the VA’s Clinical Epidemiology Center.

“In general, we always advise clinicians to evaluate whether PPI use is medically necessary in the first place because the drugs carry significant risks, including a deterioration of kidney function,” he said.

PPIs are sold under name brands such as Prevacid, Nexium and Prilosec, by prescription and over the counter, and they are taken by more than 20 million Americans in any given year. They had generally been considered by many to be safe but that opinion is changing as the drugs are being linked to more and more dangerous side effects.

The manufacturers of these drugs are being sued by hundreds of patients who allege that their serious kidney injuries were caused by PPI use and allege “negligence, design defect, failure to warn, fraudulent concealment, warranty claims and loss of consortium.”

Nephrology News
CBS News
Science Daily
Righting Injustice
Righting Injustice