March 7, 2016 — A study published in JAMA Internal Medicine has found a 20-50% increased risk of chronic kidney disease associated with some of the most popular heartburn drugs on the market.
These drugs include Nexium, Prevacid, and Prilosec, which are members of the proton pump inhibitor (PPI) class. They work by reducing the amount of acid produced in the stomach.
Researchers tracked 10,482 people between February 1996 and October 2015 and comparing rates of kidney inflammation (interstitial nephritis) between PPI-users and people on non-PPI heartburn drugs like Zantac, Tagamet, and Pepcid.
After adjusting for confounding variables, PPIs were associated with up to a 50% increased risk of Chronic Kidney Disease (CKD). The findings were replicated in a separate study involving 250,000 patients.
Higher doses of PPIs were associated with higher rates of kidney disease, suggesting a possible causal relationship. Twice-daily use of a PPI was associated with a 46% increased risk of CKD, compared to a 15% increased risk for patients on a once-daily dose.
The lead author of the study, Dr. Morgan E. Grams of Johns Hopkins University, cautioned:
“The study doesn’t prove that PPIs cause kidney disease and we don’t want to cause alarm. … One approach for patients who require a long course of PPIs would be to routinely monitor their kidney function.”
Dr. Grams said no one is sure how PPIs could damage the kidneys, but there are a few theories. The medications can cause low magnesium levels, according to an FDA warning from 2011. The kidneys could also be damaged after repeated bouts of inflammation.
Other recent studies have found that PPIs can constrict blood vessels, which can lead to high blood pressure. Over time, high blood pressure overworks the kidneys and scars the delicate filtration structures that clean the blood.
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