Acid reflux and heartburn are aggravating for sufferers, but two new studies suggest that the medications used to treat them could damage the kidneys, increasing the risk of chronic kidney disease.
The studies will be presented at the American Society of Nephrology Kidney Week 2015, which will take place next week in San Diego, CA.
The drugs in question – proton pump inhibitors (PPIs) – are in the top 10 list of prescribed medications in the US.
They work by reducing the amount of stomach acid produced by glands in the lining of the stomach, thus relieving symptoms of acid reflux, gastroesophageal reflux disease (GERD) and peptic or stomach ulcers.
Available both as prescription and over the counter, PPIs also treat damage to the lower esophagus that occurs as a result of acid reflex.
Although these drugs provide relief for many sufferers, the two new studies implicate them in raising risk of chronic kidney disease (CKD), a condition that is on the rise in the US. Currently, more than 20 million Americans have this disease, and its prevalence is growing most rapidly in people over the age of 60.
People with early CKD do not typically feel ill or notice any symptoms, so the only way to receive a diagnosis is through specific blood and urine tests.
Once diagnosed, CKD can be treated with lifestyle changes and medicines, which typically decrease the rate at which the disease progresses. Without treatment, however, the kidneys could stop working – resulting in kidney failure and either dialysis or a kidney transplant.
In one of the new studies, Benjamin Lazarus, from Johns Hopkins University in Baltimore, MD, and colleagues followed 10,482 healthy adults from 1996-2011.
- More than 10% of adults – 20 million people – may have CKD
- Chances of having the disease increase with age; it increases after 50 and is most common among adults older than 70
- Diabetes and hypertension are common risk factors for CKD.
After accounting for baseline differences between PPI users and non-users, the team found that PPI users were 20-50% more likely to develop CKD than non-users. And this discovery was replicated in a second study that followed 240,000 patients from 1997-2014.
“In both studies,” says Lazarus, “people who used a different class of medications to suppress stomach acid, known as H2-blockers, did not have a higher risk of developing kidney disease.”
He adds that if they can determine the adverse effects of PPI medications, they can “design better interventions to reduce overuse.”
In a different study, led by Dr. Pradeep Arora of the State University of New York-Buffalo, researchers found that, out of 71,516 patients, 24,149 developed CKD between 2001-2008, and nearly 26% of these patients were treated with PPIs.
The researchers also observed that those patients who took PPIs were less likely to have vascular disease, cancer, diabetes, hypertension and chronic obstructive pulmonary disease (COPD), but they had a 10% increased risk of CKD and a 76% increased risk of dying early.
Commenting on his team’s findings, Dr. Arora says:
”As a large number of patients are being treated with PPIs, health care providers need to be better educated about the potential side effects of these drugs, such as CKD. PPIs are often prescribed outside of their approved uses, and it has been estimated that up to two thirds of all people on PPIs do not have a verified indication for the drug.”
In June of this year, Medical News Today reported on a study that suggested PPIs could raise risk of heart attack by more than 20%.