Proton pump inhibitors are one of the most commonly prescribed heartburn medications. These drugs have been previously linked to different adverse health effects. A recent study explored the link between heartburn medication and kidney disease.
Proton pump inhibitors are a class of heartburn medication that is available by prescription. Some low dose proton pump inhibitors are now available without a prescription. These drugs help relieve heartburn by controlling the secretion of acid in the stomach.
Between 25-75% of prescriptions for proton pump inhibitors do not have appropriate indications. It is very common to see patients use proton pump inhibitors chronically for conditions that require short-term treatment. Patients may be exposed to unnecessary adverse effects from chronic use of proton pump inhibitors.
What are the long-term effects of these heartburn medications?
Researchers from the Department of Pharmacy Practice at the University of Buffalo in New York conducted an observational study to investigate the potential long-term adverse effects of these heartburn medications. The results of the study were published in Pharmacotherapy.
The researchers selected 177, 935 healthy patients from a large health maintenance organization group. At the end of the observation period, these patients were divided into two groups based on a diagnosis of acute or chronic kidney disease. The researchers observed the incidence rates of kidney disease among users of proton pump inhibitors.
Higher incidences of kidney disease
In both the acute kidney injury and chronic kidney disease patient groups, the researchers noted higher incidence rates of kidney disease among users of heartburn medications. Age, heart failure, diabetes, hypertension, and the use of drugs like blood pressure medicines and histamine 2 receptor blockers are other causes of kidney disease. When the researchers adjusted their data for these confounding factors, the patients taking proton pump inhibitors still had higher incidences of kidney disease.
In this observational study, chronic proton pump inhibitor use was associated with a 20% higher incidence of chronic kidney disease and a 4-fold increase in the risk of acute kidney disease. These results are consistent with previous reports on the adverse effects of chronic heartburn medication use.
A need to educate prescribers on the proper use of proton pump inhibitors
It is important to consider several limitations when evaluating this data. Acute kidney injury caused by heartburn medication may be underdiagnosed, given that proton pump inhibitors are considered safe and well-tolerated. Also, the researchers were unable to gain information on a patient’s use of over-the-counter heartburn medications. Therefore, some participants may have been using non-prescription heartburn medications and were classified as non-users.
In light of these findings, the investigators conclude that there is a need to educate prescribers on the proper use of proton pump inhibitors. A drug that was once considered to be a safe class of heartburn medications can contribute to serious effects if they are misused.
Written by Jessica Caporuscio, PharmD
- Hart E, Dunn TE, Feuerstein S, et al. Proton Pump Inhibitors and Risk of Acute and Chronic Kidney Disease: A Retrospective Cohort Study. Pharmacotherapy. 2019
- Wolters Kluwer Clinical Drug Information, Inc. (Lexi-Drugs). Wolters Kluwer Clinical Drug Information, Inc.; March 27, 2019.