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Proton Pump Inhibitors (PPIs) and Kidney Failure

According to the Healthcare Cost and Utilization Project (HCUP), up to 60 percent of the population suffers from symptoms of gastroesophageal reflux disease (GERD), such as heartburn or regurgitation. Twenty to thirty percent of Americans deal with it every week.

Patients with frequent heartburn and GERD are at a higher risk for other health problems, like esophagitis (inflammation of the esophagus), bleeding, and trouble swallowing, as well as more serious complications like esophageal cancer.

Since the 1980s, medications called “proton pump inhibitors (PPIs)” have been the go-to treatment for acid-related disorders. For decades they seemed to be very safe, but recent studies have suggested that long-term use can cause serious health problems, including chronic kidney disease and kidney failure.

What are Proton Pump Inhibitors?

The stomach naturally produces acid to help digest the food we eat. If the stomach produces too much, however, we suffer the side effects, such as heartburn and acid reflux.

PPIs are medications that can block the production of stomach acid. The stomach lining contains certain “parietal cells” that pump out hydrogen ions to create stomach acid. These cells need enzymes to do that, and PPIs neutralize those enzymes. As a result, fewer ions are pumped out, and the stomach acid becomes weaker.

After they came onto the market in the 1980s, PPIs became the most effective treatment for a number of acid-related conditions, including:

  • Acid reflux or GERD
  • Stomach ulcers
  • Damage/inflammation to the lower esophagus
  • To help heal a damaged esophagus

The main PPIs available today include:

  • Omeprazole (Prilosec and over-the-counter)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Pantoprazole (Protonix)

Proton Pump Inhibitors and Kidney Failure

Though PPIs have been linked with side effects in the past, the recent studies linking them to kidney failure have been particularly concerning.

In an April 2015 study, researchers looked at data from about 300,000 patients aged 66 and older who took PPIs between 2002 and 2011. They matched them with an equal number of controls, and found that PPIs increased risk of both acute nephritis and acute kidney injury.

In a February 2016 study, researchers examined data from about 10,500 participants who were followed between 1996 and 2011. They were split about evenly between men and women, with a mean age of 63 years. The analysis showed that those participants taking PPIs had a 20-50 percent increased risk of kidney disease compared to those who never took the drugs. Twice-daily dosing was associated with a higher risk than once-daily dosing, and the longer the patient took the medications, the greater their risk.

These results were then replicated in a second study by the same researchers. This time, they looked at data from nearly 250,000 patients from 1997 to 2014. They compared those using PPIs to those using another type of medication to suppress stomach acid (H2 blockers), and found that only those using PPIs had an increased risk of CKD.

The American Society of Nephrology reported on another study showing similar results. Led by Dr. Pradeep Arora of SUNY-Buffalo, researchers looked at data from about 70,000 patients between 2001 and 2008. They found that about a quarter of them who developed CKD had been taking PPIs. They also found that this same group had a higher risk for mortality compared to those not taking PPIs.

Researchers from this study theorized that PPIs may increase risk of kidney disease because they are known to cause nephritis (inflammation of the kidneys) and because they can reduce levels of magnesium in the blood. Over time, low magnesium levels can also damage the kidneys.

In April 2016, a third study again reported on the connection between PPIs and CKD. This time, researchers examined data from the Department of Veterans Affairs national databases including about 173,000 participants. They followed these participants over a period of five years and found that PPIs were associated with a 96 percent increased risk of kidney failure and a 26 percent increased risk of CKD.

After five years, about 15 percent of PPI users were diagnosed with kidney disease, compared to 11 percent of those taking H2-blockers. Patients taking the drugs for 1-2 years were also three times more likely to develop kidney failure than those who used them for less than a month.

Symptoms of Proton Pump Inhibitor Kidney Failure

If diagnosed early, nephritis and kidney disease can be reversed. The longer these conditions continue without treatment, however, the greater the risk of kidney failure.

Symptoms of nephritis include:

  • Pelvic pain
  • Pain or burning while urinating
  • A frequent need to urinate
  • Cloudy, bloody, or pus-filled urine
  • Pain in the kidney or abdomen areas
  • Swelling in the face, legs, and feet
  • Nausea and vomiting

Symptoms of chronic kidney disease include:

  • Nausea and vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Problems sleeping
  • Changes in urine output
  • Muscle twitches and cramps
  • Decreased mental sharpness/brain fog
  • Swelling in feet and ankles
  • Shortness of breath
  • High blood pressure

PPI Lawsuits

Manufacturers of PPI drugs have been accused of failing to conduct adequate studies on their products before releasing them on the market, and for failing to include adequate warnings about the risks of side effects.

Because of the manufacturers’ extensive advertisement campaigns, PPIs are widely used today, and are widely thought to be over-prescribed. Because doctors and patients have not been aware of some of the more serious potential side effects—like kidney disease—people have used them more than they really needed to, and usually for too long a period of time.

A 2014 study, for instance, reported that PPIs were being “abused through overuse,” that there was some evidence that improper use was rising, and that many patients were using them for four years or more.

“The improper use of PPIs can lead to unwanted adverse effects and increase the chances for drug-induced disease,” the researchers wrote, “such as gastric cancer.” They advised that the PPIs be used only when other treatments were ineffective.

A Proton Pump Inhibitor Lawyer Can Help

If you or a loved one took a proton pump inhibitor and suffered a serious injury, you may be eligible to file a proton pump inhibitor lawsuit.

Chaffin Luhana attorneys may be able to help. We understand that manufacturers are responsible for making sure their products are safe before releasing them on the market. It’s also their job to ensure doctors and patients are well aware of the risks before prescribing or taking their drugs.

At Chaffin Luhana, we are on top of the developments concerning PPIs and are happy to give you a free case consultation. Call today at 1-888-316-2311.



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