Two studies this year have examined the risk of kidney side effects with proton pump inhibitors, a class of medications that includes Nexium, Prilosec and Prevacid. PPIs lower the amount of acid produced in the stomach; they are used to relieve heartburn and acid reflux. Recent research has linked the long-term use of PPIs to an increased risk of kidney side effects. Although the findings do not indicate a causal relationship, they do underscore the need to only use PPIs when medically necessary.
A study published in JAMA Internal Medicine this January looked at data from two sources: a national survey of 10,000 people participating in a study on hardening of the arteries and outpatient PPI prescriptions among 250,000 patients in a Pennsylvania health care system. Researchers, led by Dr. Morgan Grams, an assistant professor of epidemiology at Johns Hopkins University in Baltimore, found that PPI use was associated with a 20 to 50 percent increased risk of kidney disease compared to non-users.
The use of PPIs was associated with a higher risk of chronic kidney disease over 10 years in both groups. Those using PPIs were 20 to 50 percent more likely to suffer kidney damage compared to non-users. Higher doses were also associated with an elevated risk. A twice daily dose was linked to a 46 percent increased risk while a once-daily dose was associated with a 15 percent increased risk.
In April, the American Society of Nephrology published a study suggesting that PPI usage was associated with an increased risk of kidney disease. The researchers compared 170,000 new PPI users to 20,000 new users of H2 receptor blockers, another class of medications used to reduce stomach acid. In the PPI group, the rate of chronic kidney disease was 15 percent compared to 11 percent in the H2 blocker group. After adjusting for other factors, this results in a 28 percent increased risk of chronic kidney disease associated with PPI use. End-stage renal failure only occurred in a handful of patients but the risk was 96 percent higher with PPI use.