Protonix is an anti-heartburn medication that was linked to reports of nephritis (kidney inflammation) over a decade ago, but warning labels were not updated until 2013. The longer nephritis goes undiagnosed, the higher the risk of kidney failure.
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Protonix (pantoprazole) is an intravenous antacid medication that reduces stomach acid. It belongs to a class of drugs known as Proton Pump Inhibitors (PPIs).
Protonix and Nephritis
In November 2003, researchers published the first known case report linking Protonix and nephritis. The victim was a 77 year-old woman who was on 40-mg Protonix for two months before she was hospitalized with nephritis. Her symptoms included fever, back pain, fatigue, joint pain, low urine output, and elevated serum creatinine.
FDA Updates Nephritis Warnings
The label on Protonix was updated to include acute interstitial nephritis in December 2013. According to the FDA, nephritis can occur at any time and is generally caused by a hypersensitivity reaction. Patients should stop taking Protonix if they develop nephritis.
Study Links PPIs and 3X Risk of Nephritis
In April 2015, CMAJ Open published a study involving 290,000 older adults in Canada and found a tripled increased risk of nephritis among those who started PPIs.
What is Interstitial Nephritis?
Acute interstitial nephritis causes sudden inflammation in the kidneys and swelling in the spaces between tubules, which are tiny structures in the kidneys that clean the blood. It is almost always caused by an allergic reaction to medications in the bloodstream.
Symptoms of Nephritis
- Blood in the urine
- Increased or decreased urine output
- Mental status changes (drowsiness, confusion, coma, etc.)
- Nausea, vomiting
- Swelling of the body
- Weight gain from retaining fluid
- Kidney enlargement
Permanent Kidney Problems are Common
Patients will need to stop taking any medication that might be causing kidney problems, and there are over 100 medications known to cause nephritis. With early diagnosis, most patients can recover near-normal kidney function within a few months.
However, severe cases are likely to cause permanent kidney problems, including kidney failure. About 15% of all people who are hospitalized with kidney failure have nephritis.
In studies of nephritis, researchers observed rapid improvement for 6-8 weeks followed by months of slow improvement. However, they said “permanent impairment of renal function is rather common in the disease.”
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