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

Proton pump inhibitors (PPIs) are the most commonly used drug worldwide. PPIs are benzimidazole derivatives and are basic in nature; therefore, they are dispensed in enteric-coated tablets or capsules to avoid degradation from gastric acid. When PPIs are administered by oral route of administration, they get absorbed from small intestine and cross the acidic parietal cell canaliculus. In this acidic environment, PPI is activated and produces a sulfenamide form of the drug. This activated form binds with the H⁺ K⁺ ATPase enzyme covalently, which results in irreversible inhibition of acid secretion.

Study to establish the relationship between rabeprazole (PPI) and acute interstitial nephritis (AIN).

To find the effect of PPI alone, PPI with diclofenac, PPI with ofloxacin on renal function tests.

In the present study, we are analyzing PPI (omeprazole) as a main group. The group is again divided into three subgroups containing six rats in each. The relation between PPI and AIN is observed by the administration of PPI alone. To find this relation, we combine the PPI with nonsteroidal anti-inflammatory drug (NSAID) diclofenac and antimicrobial agent ofloxacin.

Rabeprazole 20 mg/kg/day alone showed a statistically significant difference in serum creatinine and blood urea values. Rabeprazole 20 mg/kg/day and ofloxacin 60 mg/kg/day did not show a statistically significant difference in serum creatinine and blood urea values. Rabeprazole 20 mg/kg/day and diclofenac showed a statistically significant difference in serum creatinine and blood urea values.

With longer administration of PPIs, it did produce derangement of renal function tests (RFTs), and with concurrent administration of drugs like ofloxacin and diclofenac, it hastened the process of renal damage as indicated by deranged RFTs.