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[Proton pump inhibitor-induced nephrotoxicity].

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Proton pump inhibitors (PPIs) may cause kidney function decline, a subtle adverse event. If kidney function decreases without a clear cause, stopping PPIs is recommended due to population-level risks.

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Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Proton pump inhibitors (PPIs) are frequently prescribed medications.
  • PPIs are generally perceived as safe, but recent studies suggest potential adverse effects on kidney function.
  • Chronic kidney injury associated with PPIs is an emerging concern.

Purpose of the Study:

  • To present clinical cases suggestive of PPI-induced kidney function decline.
  • To discuss the epidemiological evidence, pathophysiology, and clinical presentation of PPI nephrotoxicity.
  • To raise awareness among clinicians regarding this potential adverse drug event.

Main Methods:

  • Case report presentation of two patients with suspected PPI-induced kidney injury.
  • Review of current epidemiological literature on PPI-associated nephrotoxicity.
  • Discussion of the mechanisms and clinical features of PPI nephrotoxicity.

Main Results:

  • The presented cases exhibited a decline in kidney function with a strong suspicion of PPIs as the causative agent.
  • Chronic PPI nephrotoxicity can present insidiously, making diagnosis challenging.
  • Epidemiological data support a link between PPI use and adverse kidney outcomes.

Conclusions:

  • Clinicians should consider PPI-induced nephrotoxicity in patients with unexplained kidney function decline.
  • Discontinuation of PPIs may be warranted in suspected cases.
  • Given the widespread use of PPIs, this adverse event holds significance at a population level despite a potentially low individual risk.