Yet another study has suggested that individuals who use proton pump inhibitors may be more likely to develop chronic kidney disease. The authors of the paper, which was published last month in BMC Nephrology, also surmised that the increased risk might be the result of another, often unrecognized kidney injury called acute interstitial nephritis.
To investigate the association between proton pump inhibitors and chronic kidney disease, the research team analyzed medical records from more than 99,000 patients who were treated via the Veterans Affairs Health Care Upstate New York network from April 2001 through April 2008. They then excluded 22,807 who had presented with preexisting kidney disease at the first observation. Of the 76,462 remaining patient, a total of 19,311 went on to develop chronic kidney disease. More than 24% of those who did so were taking proton pump inhibitors.
A mortality analysis of the entire 99,269 patient population indicated that 11,758 had died.
The analysis suggested that the popular heartburn drugs were associated with a 10% increase in the risk for chronic kidney disease, as well as a 76% increased chance of death.
The study authors also noted that acute interstitial nephritis secondary to proton pump inhibitor use frequently goes undiagnosed, and may later present as chronic kidney disease. This condition is characterized by the sudden inflammation of the kidney tubules, and is generally related to a hypersensitivity reaction to a medication. In 2014, the U.S. Food & Drug Administration asked the manufacturers of prescription proton pump inhibitors to include mention of acute interstitial nephritis in their drug labeling.
This is not the first time research has linked the use of drugs like Nexium to chronic kidneydisease and other renal complications. In April, for example, a paper that appeared in the Journal of the American Society of Nephrology reported that long-term users of proton pump inhibitors may be 96% more likely to develop kidney failure and 28% more likely to develop kidney disease compared to patients using another class of heartburn drugs called H2-blockers. Another study published in JAMA Internal Medicine in January also suggested that proton pump inhibitors might increase the risk of chronic kidney disease by as much as 50%.
Researchers writing in the April 2015 issue of CMAJ Open concluded that proton pump inhibitor use was associated with a 3-fold increase in the odds for acute interstitial nephritis, as well as a 2.5 times higher risk of acute kidney injury.