Prolonged Use of Proton Pump Inhibitors Increase Risk of Kidney Failure
A recent study has revealed that Nexium (esomeprazole), Prilosec and Prevacid (omeprazole), Aciphex (rabeprazole), and Protonix (pantoprazole) – medications that are commonly prescribed to treat chronic heartburn – are correlated with an increased risk of kidney disease and kidney failure. Not only may they increase your risk for these complications, but an earlier study linked them to an increased risk of heart attack. They are taken to control acid in the stomach and are prescribed to people who suffer from heartburn, acid reflux, gastroesophageal reflux disease (GERD), and ulcers. You are more likely to develop these complications if you take these medications. A clear connection has not yet been found connecting PPIs with kidney failure and heart attack, but there is still cause for concern. It is safe to make the assumption based on the information we do have that a connection probably exists.
PPIs can cause other serious side effects in addition to kidney failure and heart attack. They are also known to cause Clostridium difficile (C. diff. colitis) – a potentially fatal bacterial infection that causes gastrointestinal distress and diarrhea – and bone fractures in older woman. One study by Harvard Medical School examined 1000,000 patients over five years who were discharged with instructions to take PPIs. These individuals had a 75 percent increased risk of developing the infection, and patients that took these medications for longer were more than twice as likely. Research done prior to this study has shown that one out of every 14 adults over the age of 65 that get the bacterial infection die. Additionally, taking these medications for more than two years has been associated with a 65 percent greater risk of vitamin B12 deficiency.
It is important to note that in the above-mentioned studies those that took H2-blockers (also called H2 receptor antagonists and H2 receptor blockers) – another class of drugs that are prescribed for stomach acid – were not found to have a heightened risk of kidney disease or heart attack. They do, however, also cause vitamin B-12 deficiency and prolonged use increases this risk by 25 percent – as compared to PPIs – which do so by 65 percent.
What is a Correlation?
A correlation means that there is a not a direct, causal relationship between taking PPIs and experiencing these complications (no one can say for certain that taking them alone causes kidney failure and heart attack). It may be that individuals who take these drugs have a genetic predisposition for stomach acid issues, heart attack, and kidney failure. However, because people that take H2 blockers do not appear to be at an increased risk for these issues this argument seems unlikely.
What are the Alternatives?
Antacids and H2 receptor blockers are other types of drugs that are used to treat GERD and acid reflux. Antacids may cause kidney stones and may also increase the risk for osteoporosis so you should monitor your bone density if this is an area of concern for you. They are easy to find and most stores carry them as a generic (name brands include Tums and Rolaids). H2-blockers like Pepcid, Tagamet, and Zantac also have side effects, but again, these are not as bothersome. Other alternative treatments to consider are acupuncture, melatonin, and relaxation, but these have not been scientifically proven to be effective. Controlling what you eat will certainly help to ease symptoms but it may not be enough. Avoid foods that are high in acid such as:
- Citrus fruits (lemon, lime, orange, grapefruit)
- Processed food
- Spicy food
If all this fails you can cross your fingers and toes and hope that a better treatment is developed soon.