PROTON PUMP INHIBITORS AND THE RISK OF CHRONIC KIDNEY DISEASES: A CRITICAL REVIEW

Authors

  • SHAREEF J. Department of Clinical Pharmacy and Pharmacology, Ras Al Khaimah College of, Pharmaceutical Sciences, Ras Al Khaimah, United Arab Emirates
  • SRIDHAR S. B. Department of Clinical Pharmacy and Pharmacology, Ras Al Khaimah College of, Pharmaceutical Sciences, Ras Al Khaimah, United Arab Emirates
  • SHARIFF A. Department of Clinical Pharmacy and Pharmacology, Ras Al Khaimah College of, Pharmaceutical Sciences, Ras Al Khaimah, United Arab Emirates

DOI:

https://doi.org/10.22159/ijcpr.2020v12i5.39783

Keywords:

Acute Kidney Injury, Chronic Kidney Disease, Proton pump inhibitors

Abstract

Proton pump inhibitors (PPIs) are most widely used medications for acid related gastrointestinal disorders. Accessible evidence based studies suggest that the increased use of PPI is linked to a greater risk of developing kidney diseases. This review aims to determine the association of kidney disease with the use of proton pump inhibitor with various study designs. PubMed, Scopus and Google Scholar databases as well as a reference list of relevant articles were systematically searched for studies by using the following search terms; ‘proton pump inhibitors’, ‘acute kidney injury’, ‘chronic kidney disease’ and ‘end stage renal disease’. Both observational and randomized controlled trials (RCTs) exploring the association of PPI use with kidney disease were eligible for inclusion. A total of 8 articles, including 9 studies (n = 794,349 participants) were identified and included in the review. Majority of the studies showed a higher risk of kidney outcomes in patients taking PPIs, with effect higher of acute kidney injury (4-to 6-fold) compared with chronic kidney disease and end stage renal disease (1.5-to 2.5-fold). However, the studies suggest that the strength of evidence is weak and could not prove causation. The risk increased considerably with the use of high dose of PPIs and prolonged duration of exposure necessitates the monitoring of renal function. Exercising vigilance in PPI use and cessation of proton pump inhibitor when there is no clear indication may be a reasonable approach to reduce the population burden of kidney diseases.

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References

1. Yang Y, George KC, Shang WF, Zeng R, Ge SW, Xu G. Proton-pump inhibitors use, and risk of acute kidney injury: a meta-analysis of observational studies. Drug Des Dev Ther 2017;11:1291–9.
2. Toth Manikowski S, Grams ME. Proton pump inhibitors and kidney disease-gi upset for the nephrologist? Kidney Int Rep 2017;2:297–301.
3. Xie Y, Bowe B, Li T, Xian H, Yan Y, Al-Aly Z. Long-term kidney outcomesamong users of proton pump inhibitors without intervening acute kidneyinjury. Kidney Int 2017;91:1482–94.
4. Klatte DCF, Gasparini A, Xu H, de Deco P, Trevisan M, Johansson ALV. Association between proton pump inhibitor use and risk of progression of chronic kidney disease. Gastroenterology 2017;153:702–10.
5. Hussain S, Singh A, Habib A, Najmi AK. Proton pump inhibitors use and risk of chronic kidney disease: evidence-based meta-analysis of observational studies. Clin Epidemiol Global Health 2019;7:46-52.
6. Hung SC, Liao KF, Hung HC, Lin CL, Lai SW, Lee PC, et al. Using proton pump inhibitors correlates with an increased risk of chronic kidney disease: a nationwide database-derived case-controlled study. Fam Pract 2018;35:166-71.
7. Hart E, Dunn TE, Feuerstein S, Jacobs DM. Proton pump inhibitors and risk of acute and chronic kidney disease: a retrospective cohort study. Pharmacotherapy 2019;39:443-53.
8. Rodriguez Poncelas A, Barcelo MA, Saez M, Coll-de-Tuero G. Duration and dosing of proton pump inhibitors associated with high incidence of chronic kidney disease in population-based cohort. PLoS One 2018;13:e0204231.
9. Xie Y, Bowe B, Li T, Xian H, Balasubramanian S, Al-Aly Z. Proton pump inhibitors and risk of incident CKD and progression to ESRD. J Am Soc Nephrol 2016;27:3153–63.
10. Lazarus B, Chen Y, Wilson FP. Proton pump inhibitor use and the risk of chronic kidney disease. JAMA Intern Med 2016;176:238–46.
11. Peng YC, Lin CL, Yeh HZ, Chang CS, Wu YL, Kao CH. Association between the use of proton pump inhibitors and the risk of ESRD in renal diseases: a population-based, case-control study. Medicine (Baltimore) 2016;95:e3363.
12. Nehra AK, Alexander JA, Loftus CG, Nehra V. Proton pump inhibitors: review of emerging concerns. Mayo Clin Proc 2018;93:240-6.
13. Moledina DG, Perazella MA. Proton pump inhibitors and CKD. J Am Soc Nephrol 2016;27:2926–8.
14. Wu B, Shang W, Li Y, Ren Y, Liu Z, Wei H, et al. Association between proton pump inhibitors use and kidney diseases: a meta-analysis. Int J Clin Exp Med 2018;11:6465-73.
15. Yang H, Juang SY, Liao KF. Proton pump inhibitors use and risk of chronic kidney disease in diabetic patients. Diabetes Res Clin Pract 2019;147:67–75.
16. Hedaiaty M, Tamadon MR, Amiri A, Mahmoodnia L. Proton-pump inhibitors and risk of renal disease. J Nephropharmacol 2017;6:33-7.
17. Wyatt CM. Proton pump inhibitors and chronic kidney disease: is it time to sound the alarm? Kidney Int 2016;89:732–3.
18. Arora P, Gupta A, Golzy M. Proton pump inhibitors are associated with increased risk of development of chronic kidney disease. BMC Nephrol 2016;17:112.
19. Jaynes M, Kumar AB. The risks of long-term use of proton pump inhibitors: a critical review. Ther Adv Drug Saf 2018;10:1-13.
20. Cheema E. Investigating the association of proton pump inhibitors with chronic kidney disease and its impact on clinical practice and future research: a review. J Pharm Policy Pract 2019;12:6.

Published

15-09-2020

How to Cite

J., S., S. S. B., and S. A. “PROTON PUMP INHIBITORS AND THE RISK OF CHRONIC KIDNEY DISEASES: A CRITICAL REVIEW”. International Journal of Current Pharmaceutical Research, vol. 12, no. 5, Sept. 2020, pp. 11-14, doi:10.22159/ijcpr.2020v12i5.39783.

Issue

Section

Review Article(s)