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Acute interstitial nephritis due to omeprazole
R P Myers1, K McLaughlin, D J Hollomby
1Department of Medicine,University of Western Ontario, London, Canada.
The American Journal of Gastroenterology
|January 5, 2002
Summary
Omeprazole, a common acid reflux medication, can cause serious kidney damage like acute interstitial nephritis (AIN). Prompt diagnosis and treatment, including stopping omeprazole, can restore kidney function.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Proton pump inhibitors (PPIs) like omeprazole are widely used for acid-peptic disorders.
- While generally safe, serious adverse effects, including renal failure, have been linked to omeprazole use.
Observation:
- A case report details a 36-year-old woman with acute interstitial nephritis (AIN) after omeprazole use.
- Symptoms included nausea, vomiting, weight loss, and elevated creatinine; AIN was confirmed via renal biopsy.
- Omeprazole cessation preceded symptom improvement and creatinine normalization with corticosteroid therapy.
Findings:
- Seventeen previous cases of omeprazole-induced AIN exist.
- AIN typically develops after 2.7 months of daily omeprazole (20-40 mg).
- Symptoms often include fatigue, fever, anorexia, and nausea, with renal biopsy confirming AIN.
Implications:
- Omeprazole-induced AIN is a potential serious adverse effect requiring clinical vigilance.
- Discontinuation of omeprazole and corticosteroid treatment appear effective in managing AIN.
- Recurrence of AIN is common upon omeprazole rechallenge, highlighting the need for careful patient monitoring.