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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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The pH of urine, the drug's pKa, and the urine flow rate are vital parameters for drug reabsorption and excretion. Urinary pH varies between 4.6 and 8.0 and is influenced by diet, drug intake, and the patient's pathophysiology. It affects a drug's ionization state and reabsorption. For instance, carbohydrate-rich food produces alkaline urine promoting drug excretion, while proteins and certain medications like ascorbic acid lead to acidic urine enhancing reabsorption.
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As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Potential Kidney Risks Associated With Clinical Doses of Omeprazole: In Vivo and In Vitro Studies.

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  • 1Department of Nephrology, School of Clinical Medicine, Peking University Shenzhen Hospital, Anhui Medical University, Shenzhen, Guangdong, China.

Clinical and Experimental Pharmacology & Physiology
|July 7, 2025
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Summary

Short-term use of omeprazole (a proton pump inhibitor) shows no significant kidney damage. However, long-term use may increase inflammation and susceptibility to environmental damage by affecting gene expression.

Keywords:
drug dosagedrug safetyenvironmental susceptibilitykidneysproton pump inhibitors

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Area of Science:

  • Nephrology
  • Pharmacology
  • Molecular Biology

Background:

  • Omeprazole is a common proton pump inhibitor and anti-Helicobacter pylori medication.
  • Its potential for causing kidney damage (nephrotoxicity) remains a subject of debate.

Purpose of the Study:

  • To investigate the effects and underlying mechanisms of omeprazole on kidney cells and function.
  • To assess omeprazole's impact on cell viability, gene expression, and inflammatory markers in kidney tissues.

Main Methods:

  • In vitro studies using HK2, HPC, NRK, and 293T cells exposed to varying omeprazole concentrations.
  • RNA sequencing to analyze gene expression changes in HK2 cells.
  • In vivo studies involving animal models treated with omeprazole for 28 days.
  • Histological analysis of kidney tissues to assess inflammation.

Main Results:

  • Omeprazole induced concentration-dependent changes in cell morphology, density, and viability, with significant cell death at high concentrations (>50 μM).
  • RNA sequencing revealed that 5 μM omeprazole inhibited genes related to proliferation, metabolism, and cytokine receptors in HK2 cells, increasing susceptibility to oxidative stress.
  • Short-term animal studies (28 days) showed no significant adverse effects on body weight, organ weights, kidney/liver function, or levels of calcium and vitamin D.
  • Tissue analysis indicated increased expression of the macrophage marker F4/80, suggesting an inflammatory response.

Conclusions:

  • Therapeutic doses of omeprazole do not appear to cause clinically relevant nephrotoxicity in the short term.
  • Omeprazole can disrupt gene expression, potentially reducing cell proliferation and viability.
  • Long-term omeprazole use might increase kidney inflammation and susceptibility to environmental factors, warranting careful clinical consideration.