What are PPIs? Proton Pump Inhibitors Linked to Increased Risk of Chronic Kidney Disease

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Proton pump inhibitors (PPIs) have long been one of the most commonly used and prescribed drugs in the U.S. for years, particularly in the treatment of indigestion and acid reflux. But, studies have shown that PPIs are linked with some adverse effects and in a new findings, published in the JAMA Internal Medicine, you can add chronic kidney disease as one of the possible health risks.

The study, which took into account more than 250,000 medical records from two sets of population, suggests that these PPIs are associated with a higher risk of incident for chronic kidney disease.

The researchers considered two groups of participants in the study--- one from the Atherosclerosis Risk in Communities (ARIC) study and the other from the Geisinger Health System in Pennsylvania.

They found out that among those who use PPIs in the ARIC study, the 10-year estimated absolute risk for chronic kidney disease was 11.8 percent while the expected risk had they not used PPIs would have been just 8.5 percent. For the Geisinger Health System, the 10-year absolute risk among PPIs users was 15.6 percent, while the expected risk was 13.9 percent.

"We note that our study is observational and does not provide evidence of causality. However, a causal relationship between PPI use and CKD could have a considerable public health effect given the widespread extent of use," wrote Benjamin Lazarus, MBBS, from the Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, and the Department of Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia, and colleagues, Medscape reported.

In 2013, there were more than 15 million Americans who used prescription PPIs with a total cost of more than $10 billion. And, the study showed that around 70 percent of these prescriptions are without indication and that 25% of long-term PPI users could discontinue therapy without developing symptoms, says Lazarus.

"I think it's a pretty big concern," says Adam Schoenfeld, an internal medicine resident at the University of California, San Francisco, who wrote an accompanying editorial to the study, the NPR.org noted.

"When they first came out they weren't associated with side effects, or we didn't think they were. So we put [people] on this medication thinking: 'It's a quick fix and they're very safe.' But in actuality they're associated with a range of side effects," he added.

Schoenfeld is now urging medical practitioners to recommend alternatives such as histamine H2 receptor antagonists or lifestyle changes first before prescribing PPIs, citing the number of patients who are taking PPIs for no clear reason.