Cooperstown, NY—Proton pump inhibitor (PPI) users had a 33% increased risk of developing chronic kidney disease (CKD) or kidney failure when compared with nonusers, according to a recent conference presentation.

Results of the analysis were presented at the American Society of Neurology’s Kidney Week 2017 in New Orleans.

Among the most commonly prescribed medications worldwide, PPIs are used to treat heartburn, reflux, and ulcers by reducing gastric acid production. Recent studies raising concerns about increased kidney disease with use of the drugs have been inconsistent, leading researchers from Bassett Medical Center in Cooperstown, New York, and colleagues to conduct a meta-analysis.

A comprehensive literature review was conducted using MEDLINE and EMBASE databases through March 2017 to identify all studies that reported the risk of CKD or end-stage renal disease (ESRD) among PPIs users compared with non-PPI users. Ultimately, five studies met eligibility criteria, with 536,902 participants, the study authors report.  

Those using PPIs were found to have significantly increased risk of CKD or ESRD when compared with non-PPIs users, with a pooled risk ratio of 1.33.

“This study demonstrates a significant association between the use of PPIs and increased risks of chronic kidney disease and kidney failure,” explained Charat Thongprayoon, MD. “Although no causal relationship has been proven, providers should consider whether PPI therapy is indicated for patients. Chronic use of PPIs should be avoided if not really indicated.” 

An analysis published last year in JAMA Internal Medicine also found that PPI use is associated with a higher risk of incident CKD and called for future research to evaluate whether limiting PPI use reduces the incidence of kidney disease. Those authors note, “The increasing prevalence of CKD among communities cannot be fully explained by trends in known risk factors, such as diabetes mellitus and hypertension, suggesting that other variables may contribute to the disease process. Medication use may be a potential factor, particularly given tendencies toward polypharmacy. Identifying iatrogenic risk factors for CKD may help to promote the rational use of medications and reduce the burden of CKD worldwide.”