Research Links PPIs to Dementia, Kidney Injury

Proton pump inhibitors (PPIs) are a class of drugs used to treat conditions such as gastric reflux and peptic ulcers. Well-known brand names include Prevacid (lansoprazole), Nexium (esomeprazole), and Prilosec (omeprazole). Medscape reports that the medications have been linked to various side effects, including dementia and kidney disease.

In February, a study published in JAMA Neurology suggested a link between PPI use and dementia. Researchers used data from the largest German health insurer to view records of 73,679 participants ages 75 and older from 2004 and 2011. Regular PPI users, defined as having had at least one prescription for one of the drugs every four or five months over an 18-month period, totaled 2,950. The study found that regular PPI use was associated with a 44 percent increased risk of dementia.

Recent studies have also suggested a link to kidney disease. JAMA Internal Medicine published a recent study showing that PPI use was associated with a higher risk of chronic kidney disease. Researchers analyzed data from a total of over 10,400 patients and conducted a 12-year follow up. The findings were replicated in a cohort of over 248,000 patients.

According to Medscape, PPIs have also been linked to acute kidney injury. A study published last April compared acute kidney injury in patients who started PPIs within 120 days to those who did not. “These new concerns for CKD, acute kidney injury, and possibly dementia associated with PPIs join a long list of other concerns about side effects from PPIs (Table). Those include decreased calcium absorption and increased fracture risk, decreased iron absorption, and poor magnesium absorption. There have been a number of studies in the last 5 years that have documented an association between chronic PPI use and hypomagnesemia, most likely due to decreased intestinal absorption. Some experts have speculated that poor magnesium absorption and hypomagnesemia predispose patients to kidney injury.” Medscape reports.

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