Acid Reflux Medications May Increase Kidney Disease Risk

New research presented at ASN Kidney Week 2015 found that use of proton pump inhibitors (PPIs) is associated with increased risk for chronic kidney disease (CKD). PPIs are commonly used to treat acid reflux, stomach ulcers, and other acid-related gastrointestinal conditions.

In one study, PPI users were between 20% and 50% more likely to develop CKD than non-PPI users, even after accounting for baseline differences between users and non-users.

For this study, Benjamin Lazarus, MBBS, of Johns Hopkins University and his colleagues followed 10,482 adults with normal kidney function from 1996 to 2011.

They found similar results in a second study in which over 240,000 patients were followed from 1997 to 2014.

In both studies, individuals who used H2-blockers to suppress stomach acid did not have a higher risk of developing kidney disease, according to Dr. Lazarus. “If we know the potential adverse effects of PPI medications we can design better interventions to reduce overuse,” he said.

In another large study, Pradeep Arora, MD, of SUNY, Buffalo, and his team found that PPI use was linked with a 10% increased risk of CKD and a 76% increased risk of dying prematurely. They looked at records of 24,149 patients who developed CKD between 2001 and 2008—out of a total of 71,516 patients—25.7% of whom were treated with PPIs. Among all patients studied, those who took PPIs were less likely to have vascular disease, cancer, diabetes, hypertension, and chronic obstructive pulmonary disease, despite their increased risk for CKD and for dying prematurely.

“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 Dr. Arora. “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.”

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“Proton Pump Inhibitor Use is Associated with Incident Chronic Kidney Disease” (Abstract SA-OR005).

“Proton Pump Inhibitors Are Associated with Increased Risk of Development of Chronic Kidney Disease” (Abstract TH-PO574).