Time to Limit Proton Pump Inhibitors?
March 1, 2016
Proton pump inhibitors (PPI) have been associated with bone loss, intestinal infections, and pneumonia. Now, a new study suggests the commonly used drugs may be associated with chronic kidney disease (CKD), especially at high doses. More than 10,000 participants with normal renal function were followed from the late 1990s to December 2011. Self-reported PPI use and prescription database PPI use was compared to use of an H2 blocker. The mean age was 63 years and 44% were male. PPI use was associated with an increased incidence of CKD in unadjusted analysis (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.11-1.90). When the analysis was adjusted for demographic, socioeconomic, and clinical variables, the HR was still 1.50 (CI, 1.14-1.96). PPI use was associated with CKD in all analyses, including time-varying in new-user design. Twice-daily PPI dosing was associated with a higher risk than once-daily dosing. The authors concluded that PPI use is associated with a higher risk of incident CKD and further research is needed to evaluate whether limiting PPI use reduces the risk (JAMA Intern Med 2016;176:238-246. doi:10.1001/jamainternmed.2015.7193). An accompanying editorial highlighted other risks of PPIs, including hypomagnesemia, infections, cardiovascular events, and fractures, and suggested patients and clinicians discuss the risks and benefits of long-term treatment (JAMA Intern Med 2016;176:172-174. doi:10.1001/jamainternmed.2015.7927). PPIs were added to the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults last October (doi: 10.1111/jgs.13702).
A new study suggests the commonly used drugs may be associated with chronic kidney disease.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content