Study to Establish the Relationship between Rabeprazole (PPI) and Acute Interstitial Nephritis (AIN).

Area of Science:

• Pharmacology
• Nephrology
• Drug Safety

Background:

• Proton pump inhibitors (PPIs), commonly used benzimidazole derivatives, are administered orally and activated in acidic environments to irreversibly inhibit acid secretion by binding to the H+/K+ ATPase enzyme.
• Their basic nature necessitates enteric coating to prevent degradation in gastric acid.

Purpose of the Study:

• To investigate the relationship between rabeprazole (a PPI) and acute interstitial nephritis (AIN).
• To evaluate the effects of PPI monotherapy and combination therapy with diclofenac (NSAID) or ofloxacin (antimicrobial) on renal function tests.

Main Methods:

• The study utilized omeprazole as the main PPI group, divided into three subgroups of six rats each.
• The relationship between PPIs and AIN was assessed through PPI administration alone and in combination with diclofenac and ofloxacin.

Main Results:

• Rabeprazole (20 mg/kg/day) alone significantly altered serum creatinine and blood urea values.
• Concurrent administration of rabeprazole (20 mg/kg/day) and diclofenac significantly impacted renal function tests.
• Rabeprazole (20 mg/kg/day) combined with ofloxacin (60 mg/kg/day) did not show statistically significant changes in serum creatinine and blood urea.

Conclusions:

• Prolonged administration of PPIs can lead to deranged renal function tests, indicating potential renal damage.
• Concurrent use of PPIs with ofloxacin and diclofenac appears to expedite the process of renal damage, as evidenced by altered renal function tests.