Commonly used heartburn medications, otherwise known as proton pump inhibitors (PPIs), are linked to an increased risk for kidney failure and kidney disease. Introduced in the late 1980s for the treatment of acid-related disorders of the upper gastrointestinal tract, such as peptic ulcers (stomach ulcers) and gastroesophageal reflux disease (GERD), PPIs are available by prescription and over-the-counter. Familiar PPIs include Nexium, Prilosec and Prevacid, and there are others. These medications suppress the production of gastric acid by neutralizing enzymes involved, thereby reducing gastric acid and alleviating symptoms of conditions like stomach ulcers, GERD and acid reflux.

According to the National Health and Nutrition Examination Survey, the use of PPIs has increased in the United States from 3.4 percent to 7.0 percent among men and from 4.8 percent to 8.5 percent among women from 1999-2000 to 2011-2013, and in 2012 alone, 14.9 million patients received 157 million prescriptions for PPIs. By 2015, not only were PPIs a preferred treatment for heartburn, but PPIs became among the most widely prescribed medications in the world.

Nonetheless, PPIs affect more than gastric cells. Common adverse effects of PPIs include nausea, headache, dizziness, and abdominal pain. However, associations have also been found between PPI use and more serious adverse events including significant kidney problems such as Acute Interstitial Nephritis (AIN), Acute Kidney Injury (AKI or Acute Renal Failure) and Chronic Kidney Disease (CKD). Acute Interstitial Nephritis (AIN) is a condition where the spaces between the tubules of the kidney cells become inflamed. Acute Kidney Injury (AKI) is a syndrome that results in a sudden decrease in kidney function or kidney damage. Chronic Kidney Disease (CKD) describes the gradual loss of kidney function. As CKD advances, dangerous levels of fluid, electrolytes and wastes can build up in the body.

PPIs have been linked to kidney problems as early as the 1990s, the most notable problem being AIN. PPI use was first linked to AIN in 1992 via case reports. Observational studies in 2014 and 2015 provided further evidence of the link between PPIs and AIN. In fact, a recent study examining the risk of AIN in a population of patients receiving PPIs, found that individuals with PPI treatment had a more than twofold increase in the short-term risk for hospital admission with acute kidney injury relative to patients who were not prescribed PPIs. Individuals age 60 or older using PPIs are considerably more at risk for developing AIN than younger users. While individuals who suffer from AIN could recover, most will suffer from some level of permanent kidney function loss. In rare cases, individuals suffering from PPI-induced AIN will require kidney transplant.

Lawyers in our firm are currently investigating cases involving PPI use and Acute Interstitial Nephritis (AIN), Acute Kidney Injury (AKI or Acute Renal Failure) and Chronic Kidney Disease (CKD). If you would like more information, contact Roger Smith or Jenna Fulk, lawyers in our Mass Torts Section, at 800-898-2034 or by email at Roger.Smith@beasleyallen.com or Jenna.Fulk@beasleyallen.com.

Sources: CMAJ Open. 2015; 3(2):E166-E171, New York Times, CBS News, Reuters



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