Common Rx Class Linked to Kidney Disease

Proton pump inhibitors may increase chronic kidney disease risk

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Proton pump inhibitors (PPIs) are quickly becoming the treatment of choice for many US patients with heartburn and acid reflux. But these patients may unknowingly be putting themselves at risk for serious complications.

Two new studies from Johns Hopkins University and State University of New York (SUNY) at Buffalo found that PPIs — a class of drugs used to treat acid reflux and other gastrointestinal conditions — may increase the risk of chronic kidney disease (CKD).

According to the authors of these studies, PPIs are among the top 10 most commonly prescribed drugs in the US. Drugs within this class include omeprazole (brand name Prilosec), esomeprazole (Nexium) and lansoprazole (Prevacid), among others.

"As a large number of patients are being treated with PPIs, health care providers need to be better educated about the potential side effects of these drugs, such as CKD," said lead study author Pradeep Arora, MD, a professor of a nephrology at SUNY Buffalo, in a press release. "PPIs are often prescribed outside of their approved uses, and it has been estimated that up to two-thirds of all people on PPIs do not have a verified indication for the drug."

CKD is a condition marked by a gradual loss of kidney function over time. The main job of the kidneys is to remove waste and excess water from the body.

In the early stages of CKD, patients may have few signs or symptoms. CKD can eventually progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

For the first study, a team of researchers led by Benjamin Lazarus, MBBS, of Johns Hopkins, looked at 10,482 US adults with normal kidney function between 1996 and 2011. The patients who took PPIs were between 20 and 50 percent more likely than those who didn't take the drugs to develop CKD during that time.

When Dr. Lazarus and team looked at more than 240,000 patients with normal kidney function between 1997 and 2014, they found similar results.

"In both studies, people who used a different class of medications to suppress stomach acid, known as H2-blockers, did not have a higher risk of developing kidney disease," Dr. Lazarus said. "If we know the potential adverse effects of PPI medications we can design better interventions to reduce overuse."

For the second study, a team of researchers led by Dr. Arora looked at 71,516 patients with normal kidney function between 2001 and 2008. Of those patients, 24,149 developed CKD. And among those who developed CKD, 25.7 percent were treated with PPIs.

However, PPIs were also linked to a reduced risk of vascular disease, cancer, diabetes, high blood pressure and chronic obstructive pulmonary disease (COPD).

These studies were presented at the American Society of Nephrology Kidney Week 2015. Research presented at conferences may not have been peer-reviewed.

Information on funding sources and conflicts of interest was not available at the time of publication.

Review Date: 
October 26, 2015
Last Updated:
October 27, 2015