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Heartburn pills may up chronic kidney disease risk: study

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Washington :People who use popular heartburn drugs, prescribed for reducing acid in the stomach, may be at an increased risk of developing chronic kidney disease, a new study has claimed.

Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications in the US and an estimated 25 per cent to 70 per cent of these prescriptions may have no appropriate indication for use.

Other observational studies have linked PPIs to serious adverse health outcomes. However, the researchers said that no population-based studies, to their knowledge, have looked at the association between PPI use and the risk of chronic kidney disease (CKD).

Morgan E Grams, of Johns Hopkins University in US and coauthors quantified the association between PPI use and incident CKD in the general population using data on self-reported PPI use in the Atherosclerosis Risk in Communities (ARIC) study (10,482 participants followed up for a median of nearly 14 years) and an outpatient PPI prescription in the Geisinger Health System in Pennsylvania (248,751 participants followed up for a median of six years).

At baseline, PPI users in both groups were more likely to have a higher body mass index and take antihypertensive, aspirin or statin medications.

In the ARIC group, there were 56 incident CKD events among 322 baseline PPI users (14.2 per 1,000-person years) and 1,382 events among 10,160 baseline nonusers (10.7 per 1,000 person-years).

PPI use was associated with risk of incident CKD in unadjusted and adjusted analyses.
The 10-year estimated absolute risk of CKD among the 322 baseline PPI users was 11.8 per cent while the expected risk had they not used PPIs was 8.5 per cent, according to the results.

In the group at Geisinger, there were 1,921 incident CKD events among 16,900 baseline PPI users (20.1 per 1,000 person-years) and 28,226 events among 231,851 baseline nonusers (18.3 per 1,000 person-years).

PPI use was associated with risk of incident CKD in analyses. The 10-year absolute risk of CKD among the 16,900 baseline PPI users was 15.6 per cent and the expected risk had they not used PPIs was 13.9 per cent, results showed.

“More than 15 million Americans used prescription PPIs in 2013, costing more than USD 10 billion. Study findings suggest that up to 70 per cent of these prescriptions are without indication and that 25 per cent of long-term PPI users could discontinue therapy without developing symptoms,” the researchers said.

“Indeed, there are already calls for the reduction of unnecessary use of PPIs,” they said.
The study was published in the journal JAMA Internal Medicine.

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