Saint Louis—Long-term use of proton pump inhibitors (PPIs) appears to be harmful to the kidneys and probably should be avoided, according to a new study.
The report, published online early by the Journal of the American Society of Nephrology, suggests that the drugs, used to treat heartburn, acid reflux, and ulcers, might not only increase the risk of developing chronic kidney disease but could also increase the risk of its progression to complete kidney failure.
The 5-year study, conducted by researchers from the Veterans’ Affairs (VA) Saint Louis Health Care System and Washington University in Saint Louis, compared records of more than 170,000 new users of PPIs to more than 20,000 users of histamine H2 receptor blocker.
Background information in the article notes that in 2013, an estimated 15 million Americans were prescribed PPIs—a likely underestimation since some formulations are available OTC.
For the study, the researchers analyzed information from the VA’s national databases, identifying 173,321 new users of PPIs and 20,270 new users of histamine H2 receptor blockers. Results indicate that, over 5 years of follow-up, veterans taking PPIs were more likely to experience kidney function decline than those taking H2 receptor blockers.
The study reports that PPI users had a 28% increased risk of developing chronic kidney disease and a 96% increased risk of developing kidney failure. Furthermore, there was a graded association between duration of PPI use and risk of kidney problems, with those who took PPIs for a longer time being more likely to develop kidney issues.
“The results emphasize the importance of limiting PPI use only when it is medically necessary, and also limiting the duration of use to the shortest duration possible,” co-author Ziyad Al-Aly, MD, said in an American Society of Nephrology press release. “A lot of patients start taking PPIs for a medical condition, and they continue much longer than necessary.”
The results also provide insights for future investigations on drug safety, added lead author Yan Xie, MPH, who pointed out, “The study serves as a model to leverage the availability of Big Data –with VA data being a prime example—and advanced analytics to determine long term safety profiles of commonly used medications and promote pharmacovigilance.”
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