Popular Heartburn Drug Causes Kidney Disease with no Warning

Every day we learn that common drugs we assumed to be safe aren’t. The latest casualty of the science of safety are the proton pump inhibitors frequently prescribed for heartburn as well as for ulcers. A new study now warns that they can lead to long-term kidney disease. . . .

Proton pump inhibitors (PPI) like Losec, Nexium, Prilosec and Prevacid relieve heartburn by supressing stomach acid. They are known to be associated with acute kidney injury, chronic kidney disease and progression to end-stage renal disease. The key, though, is that doctors previously thought they could catch the problem before it became chronic because they would see the acute kidney problems that happened on the way. Turns out, that’s not true.

When the researchers compared 125,596 people who used PPIs to 18,436 people who used over the counter histamine H2 antagonists (H2 blockers) for the same problem over a 5 year period, they found that the ones using PPIs had 26% more chronic kidney disease.

But what’s really dangerous is that the assumption about catching chronic kidney disease turned out to be false. Only about half the people who developed chronic kidney disease as a result of taking PPIs had acute kidney disease first.

So, not only are PPIs a significant cause of chronic kidney disease and progression to end stage kidney disease, but the researchers warn that the increased risk of chronic kidney disease is often not flagged by prior acute kidney disease. That means that taking a common drug for the symptoms of heartburn could lead to chronic kidney disease without any warning. This is potentially important since results of the National Health and Nutrition Examination Survey estimate that at least 7.8% of US adults had used prescription PPIs in the previous 30 days.

And this is not the only danger of PPIs. PPIs have also been associated with

•increased risk of pneumonia (World J Gastrointest Pharmacol Ther 2011;2:17-26; Expert Rev Clin Pharmacol 2012;5:337- 44)

•increased risk of vitamin B12 deficiency

•44% increased risk of dementia (JAMA Neurol 2016; doi:10.1001/jamaneurol.2015.4791)

•increased risk of osteoporosis and of osteoporosis related fractures (CMAJ 2008;179:319-26; BMJ 2012;344:e372)

•16% increased risk of heart attack and double the risk of dying from a heart attack (PLoS One 2015;10:e0124653).

And another study just demonstrated once again that PPIs increase the risk of chronic kidney disease (JAMA Intern Med 2016;176:doi:10.1001/jamainternmed.2015.7193).

All of this from a drug for treating heartburn and ulcers, which can safely be treated by licorice.

Kidney International 2017;doi:org/10.1016/j.kint2016.12.021

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