Proton Pump Inhibitors May Accelerate Kidney Decline, Raise Heart Risks in Patients with Type 2 Diabetes

Published on June 20, 2017 by Sandy Liebhard

Proton pump inhibitors may not be the best choice for adults with Type 2 diabetes. According to a new study published in Endocrinology Today, Type 2 diabetics who initiate treatment with these drugs may experience an acceleration of diabetes-related kidney decline, as well as an increase in their 5-year cardiovascular risk compared to those who do not.

The authors of the study analyzed data from patients who had been recruited between 2008 and 2011 for the Fremantle Diabetes Study Phase II. All had Type 2 diabetes and where prescribed stable renin-angiotensin system blocking therapy. During follow-up, the subjects completed questionnaires, physical exams and provided fasting blood samples at baseline, as well as biennial face-to-face assessments and mailed questionnaires

Study participants were divided into four groups:

• Those who remained off proton pump inhibitor therapy throughout follow-up. (Group 1, 686 patients)
• Those who remained on proton pump inhibitor therapy throughout follow-up. (Group 2, 174 patients)
• Those who commenced proton pump inhibitor therapy and had a biennial assessment either before or after the change, with an average duration of therapy of at least 12 months. (Group 3, 109 patients)
• Those who were taking a proton pump inhibitor and had discontinued the medication at the next face-to-face interview, with an average duration off-therapy of at least 12 months, (Group 4, 67 patients)

“The present data provide a note of caution in the context of type 2 diabetes,” the study authors concluded. “Regular assessment of their appropriateness as part of chronic pharmacotherapy as well as regular monitoring of renal function during chronic use appear important, and there is an argument that CVD risk factor management should be optimized if [proton pump inhibitors] are prescribed given the present association with CVD risk after their initiation.”

Proton Pump Inhibitors Linked to Kidney Complications

This is not the first study to suggest that proton pump inhibitors could be associated with some serious risks. Previous research has linked their long-term use to an increased risk of dementia, B12 deficiency, low magnesium levels and heart attacks. Most recently, studies have suggested that long-term proton pump inhibitor use may lead to serious kidney complications, including kidney failure, chronic kidney disease, acute kidney injury and other renal problems.

More than 170 proton pump inhibitor lawsuits are currently pending in U.S. courts claim that the manufacturers of Nexium, Prilosec and PrevAcid have been aware for years that these medications could potentially harm the kidneys, yet failed to issue appropriate warnings to doctors and patients. Plaintiffs further assert that they could have avoided their injuries had they received proper notice of these risks.

Next month, the U.S. Judicial Panel on Multidistrict Litigation (JPML) will consider a proposal to centralize all federally-filed claims of this nature in a single U.S. District Court for the purposes of coordinated pretrial proceeding. This will mark the second time the Panel will take up this matter, having rejected a similar proposal earlier this year. At the time, the JMPL cited several factors for its decision, including the small number of cases pending at that time.