Researchers at the Missouri’s Clinical Epidemiology Center at the VA St. Louis Health System and Washington University in St. Louis have demonstrated that the long-term use of proton pump inhibitors (PPI) leads to damaging effects on the kidneys. The research article, “Proton Pump Inhibitors and Risk of Incident CKD and Progression to ESRD,” was published in the Journal of the American Society of Nephrology.
PPIs reduce gastric acid production and are the most common drug class used for heartburn, ulcers, or acid reflux. In 2013 alone, at least 15 million Americans were prescribed PPIs — probably more due to the over-the-counter availability of this medication. Although PPIs are generally perceived as safe, they are overprescribed and their use is often extended for long-term duration without appropriate medical indication, according to the study.
Researchers led by Yan Xie and Ziyad Al-Aly analyzed data from the Department of Veterans Affairs national databases to identify 173,321 new users of PPI and 20,270 new users of histamine H2-receptor antagonists (H2 blockers), an alternative acid-suppression therapy. Patients were followed for more than five years to detect renal outcomes, and results revealed that those taking PPIs were 28 percent more likely to develop chronic kidney disease and had a 96 percent increased risk of end-stage renal disease (ESRD) when compared to patients taking H2 receptor blockers.
Researchers also demonstrated a graded association between the duration of exposure to the medication and the risk of renal outcomes, with patients taking PPIs for a longer time being more likely to develop CKD, to suffer from CKD progression, and end-stage renal disease.
Due to the wide use and overprescription of PPIs, these findings may be beneficial for public health, since a medication that was generally perceived as safe and was commonly overprescribed may be linked to an increased risk of developing kidney problems, such as chronic kidney disease and kidney failure, suggesting their long-term use should be avoided.
“The results emphasize the importance of limiting PPI use only when it is medically necessary, and also limiting the duration of use to the shortest duration possible,” Al-Aly said in a press release.