Chronic Kidney Disease Patients Appear to Use Proton Pump Inhibitors Longer

Published on September 17, 2018 by Sandy Liebhard

New research has found that patients with chronic kidney disease are prescribed proton pump inhibitors longer than average, even though the popular heart burn drugs could actually exacerbate their condition.

Study Authors: Doctors Should Be Cautious in Prescribing Proton Pump Inhibitors to those with Chronic Kidney Disease

The study, which appeared online in PLoS One, involved 178,228 patients who had received care at a hospital outpatient clinic.

According to the study authors, median duration of proton pump inhibitor use was:

• 120 days among patients with stage 3-4 chronic kidney disease
• 106 days among those with stage 5 chronic kidney disease or end-stage renal disease
• 90 days among those with normal kidney function

The differences between stage 3-4 kidney disease patients and those with normal renal function remained, even when the authors adjusted for age and sex.  They concluded that doctors are prescribing proton pump inhibitors to chronic kidney disease patients for longer durations in spite of their potentially toxic renal side effects.

“Every medication should be cautiously considered for side or unexpected effects to reduce progression of underlying diseases such as CKD,” they wrote. “Physicians should pay attention to and consider appropriate indications when prescribing PPIs to CKD patients, especially patients at high risk for aggravation of renal impairment.”

Proton Pump Inhibitor Kidney Side Effects

Proton pump inhibitors like Nexium, Prilosec and Prevacid are prescribed to more than 15 million Americans every year to prevent GERD and other problems associated with the excess production of gastric acid.

Because they have become so commonplace, most people give little thought to proton pump inhibitor side effects. However, numerous studies have suggested that extended treatment with these medications could be harmful to the kidneys.

In December 2014, for example, the labels for all prescription versions were updated to note acute interstitial nephritis as a possible proton pump inhibitor complication This condition causes a sudden inflammation of the kidneys and often results from a toxic drug reaction. Untreated, acute interstitial nephritis can progress to chronic kidney disease and renal failure.

In 2015, a study published in CMAJ Open reported that seniors who began treatment with proton pump inhibitors were three times more likely to suffer from acute kidney injury compared to their peers who did not take the medications.

That study was followed by research in JAMA: Internal Medicine that linked long-term proton pump inhibitor use a nearly 50% increased risk of chronic kidney disease, while a study published in the Journal of the American Society of Nephrology suggested long-term users were 96% more likely to develop kidney failure and 28% more likely to suffer chronic kidney disease compared to those who took another class of heart burn medication.

Proton Pump Inhibitor Lawsuits

In recent years, thousands of patients have filed proton pump inhibitor lawsuits alleging that their long-term use of Nexium and similar drugs resulted in serious kidney damage, including acute interstitial nephritis, acute kidney injury, chronic kidney disease, and kidney failure.

Among other things, plaintiffs point to the growing body of scientific research that has found such a link. They further allege that defendants have been aware for years that drugs like Nexium could harm the kidneys, but failed to adequately warn the public in order to protect sales of the medications.