The drugs are sold under the brand names Prevacid, Prilosec, Nexium, and Protonix, among others. More than 15 million Americans have prescriptions for PPIs, although the number of people taking PPIs is likely higher because the figure does not include PPIs bought over-the-counter without prescriptions. (Credit: Wikimedia Commons)
Drugs used to treat heartburn and acid reflux may damage kidneys and lead to kidney failure, new research shows. And the risk of kidney problems rises the longer people take the medications.
The drugs, called proton pump inhibitors or PPIs, are sold under the brand names Prevacid, Prilosec, Nexium, and Protonix, among others.
Ziyad Al-Aly, the study’s senior author and an assistant professor of medicine at Washington University in St. Louis, advises people to use the medications for the shortest duration possible.
“The general assumption is that PPIs as a drug class are safe,” adds Al-Aly. “PPIs do not receive the same level of scrutiny as many other drugs in terms of indication for initiating treatment and duration of therapy.”
Al-Aly and colleagues identified 173,321 new users of PPIs and 20,270 new users of an alternative class of stomach-acid suppressing drugs called histamine H2 receptor blockers.
Following the patients for five years, the researchers found that chronic kidney disease affected 15 percent of PPI users who took the drugs over the course of the study compared with 11 percent of H2 blockers. After controlling for factors such as age and other health conditions that PPIs were associated with, researchers found a 28 percent increased risk of kidney damage among PPI users.
PPI users also were at a significantly higher risk—98 percent—of developing kidney failure compared with users of H2 blockers, although this occurred in less than 1 percent of the overall patients studied.
Their findings appear in the Journal of the American Society of Nephrology.
More than 15 million Americans
Similar studies—including one published earlier this year by researchers at Johns Hopkins University in The Journal of the American Medical Association—reached similar conclusions about the elevated risks of PPIs. Other studies have linked PPIs to health problems such as fractured bones and infections.
The new research does not provide direct evidence that PPIs cause kidney damage. However, potential negative connections need to be taken seriously, especially since PPI use is so widespread, says Yan Xie, the study’s lead author and a biostatistician at the Clinical Epidemiology Center.
More than 15 million Americans have prescriptions for PPIs. Xie says that the number of people taking PPIs is likely higher because the figure does not include PPIs bought over-the-counter without prescriptions. The drugs are popular because they quickly relieve symptoms.
“The constellation of findings—the totality of evidence—is compelling,” Xie says. “The public and the medical community should be aware of the possible risk and should exercise judicious use of PPI.”
The researchers called for further study about the safety of PPIs.
About the Authors
Scientists from the Veterans Affairs St. Louis Health Care System collaborated on the study.
Source: Washington University