Certain Heartburn Medications Linked to Chronic Kidney Disease

Certain types of heartburn medications called proton pump inhibitors (PPIs) could be linked to long-term kidney damage, according to a new study. Medications like Nexium, Prevacid and Prilosec are members of a class of medications that treat heartburn and acid reflux, through lowering the amount of stomach acid a person has in their body.

The Study

People who use proton pump inhibitor drugs have a 20-50 percent higher risk of developing chronic kidney disease, when compared with nonusers. The lead study author was Dr. Morgan Grams, assistant professor of epidemiology at Johns Hopkins University in Baltimore and the results were published in the January 11, 2016 edition of JAMA Internal Medicine.

As many as 70 percent of prescription medications have been given out inappropriately, while 25 percent of long-term users could quit using the medication without having an increased in acid reflux or heartburn.

Using these medications has been linked to short-term kidney problems such as acute kidney injury and the inflammatory kidney disease known as acute interstitial nephritis, Dr. Grams said.
Newer studies have shown a link between these medications and chronic kidney disease, in which the kidneys lose their ability to properly cleanse and filter the blood.

With time, chronic kidney disease can result in renal failure, which means a person will need to go through regular dialysis and possibly need to have a transplant, according to the U.S. National Institutes of Health.

In the most recent study, the research team used information on self-reported PPI use among 10,000 individuals participating in a national study on the arterial hardening. The team also reviewed data on outpatient PPI prescriptions among 250,000 patients of a health care facility in Pennsylvania.

From the beginning of the study, people who use proton pump inhibitors were more likely to have health issues like high blood pressure, obesity and heart problems.

The team also compared individuals using the medication once a day with people who used them twice per day. They found that using the drug two times a day was associated with a 46 percent increased risk of chronic kidney disease, versus a 15 percent increased risk in those using the medicine once daily.

Nobody can be sure of how these drugs might cause damage to the kidneys, but there are some theories. The medications might cause magnesium levels to decline in the body, and lacking this important mineral may cause kidney damage. Another theory reports that kidney damage could occur over time, if the patient suffered from repeated bouts of acute kidney inflammation because of PPI use.

Gastroenterologists are already cautious about the use of these medications, because they have been linked to other health issues such as infections of C. difficile, bone fractures and pneumonia.
Dr. Arun Swaminath, the director of the inflammatory bowel disease program at Lenox Hill Hospital in NYC said, “We have started to limit the time you have to be on it, and limit the amount you take.”

In Closing:

Because the new study wasn’t a clinical trial, it does not prove conclusively that extended PPI use causes chronic kidney disease. More study is needed to determine the safety and efficacy of PPI use and people who use these medications should speak to their doctor about whether or not they really need them.