Common Heartburn Drugs May Increase Risk for Kidney Disease

Proton pump inhibitors (PPIs)—widely used heartburn medicines—may increase the risk for kidney disease.

PPIs are sold under brand names, including Nexium, Prevacid and Prilosec, in both prescription and over-the-counter formulas. Proton pump inhibitors (PPIs) greatly reduce the amount of acid produced by the stomach lining, and this reduces irritation of the stomach lining and allows ulcers and irritation of the esophagus to heal, according to WebMD.

In a study just published online in JAMA Internal Medicine, researchers followed 10,482 people for an average of 13.9 years, comparing those who used PPIs to nonusers and to those who used another type of heartburn medicine—H2 receptor antagonists (brand names such as Zantac, Tagamet and Pepcid), the New York Times reports. After adjusting for many variables, the researchers found that the use of P.P.I.s was independently associated with a 20 percent to 50 percent higher risk of chronic kidney disease. (The use of H2 receptor antagonists was not independently associated with kidney problems.)

The researchers validated the association in a separate group of 250,000 patients receiving care in a large rural health care system.

Other studies have linked the use of PPIs to bone fracture, pneumonia and Clostridium difficile infection, according to the New York Times. C. difficile usually occurs when someone has taken antibiotics that change the normal colon bacteria allowing the C. difficile bacteria to grow and produce toxins. A study published in June 2015 in PLOS One showed that people who take proton pump inhibitor drugs for gastroesophageal reflux disease (GERD) are at increased risk for heart attacks.

The study’s senior author, Dr. Morgan E. Grams, a kidney specialist at Johns Hopkins, said, “The study doesn’t prove that P.P.I.s cause kidney disease,” according to the Times. The authors “don’t want to cause alarm. P.P.I.s are great medicines, and sometimes life saving. But like all medications, there are risks and benefits.” Grams says doctors can approach the risk of kidney disease by routinely monitoring kidney function in patients who require a long course of PPIs.


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