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PPIs and kidney disease: from AIN to CKD
Dennis G Moledina1,2, Mark A Perazella3,4
1Section of Nephrology, Yale University School of Medicine, BB 114, 330 Cedar Street, New Haven, CT, 06520, USA.
Journal of Nephrology
|April 14, 2016
Summary
Proton pump inhibitors (PPIs) are linked to acute interstitial nephritis (AIN), a kidney condition. Long-term PPI use increases the risk of kidney damage and chronic kidney disease (CKD).
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Proton pump inhibitors (PPIs) are widely used globally for acid-related gastrointestinal disorders.
- While generally safe, concerns exist regarding PPIs' association with adverse renal events, particularly acute interstitial nephritis (AIN).
- PPIs are a leading cause of drug-induced AIN due to their extensive and prolonged use.
Purpose of the Study:
- To clarify the population incidence of PPI-induced AIN.
- To determine the contribution of PPI-induced AIN to the overall burden of chronic kidney disease (CKD).
Main Methods:
- Review of two population-based studies investigating PPI use and kidney outcomes.
- Analysis of evidence on intermediate to longer-term follow-up after PPI-induced AIN episodes.
Main Results:
- Population-based studies indicate an increased risk of AIN and acute kidney injury in patients prescribed PPIs.
- Evidence suggests a lower estimated glomerular filtration rate (eGFR) in patients post-AIN following PPI use.
- Patients prescribed PPIs demonstrate a higher risk of developing CKD.
Conclusions:
- PPIs are a significant cause of drug-induced AIN.
- PPI use is associated with an increased risk of acute kidney injury and CKD.
- The findings highlight the importance of monitoring renal function in patients on long-term PPI therapy.
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