Proton Pump Inhibitors and the Risk of Acute Kidney Injury

proton-pump-inhibitorIf you use proton pump inhibitors, a type of commonly prescribed medication for heartburn and acid reflux disease, you should be aware of a serious risk. Research has found that these medications could dramatically increase your chances of suffering kidney failure.

Proton pump inhibitors — which include well-known medication brands like Prilosec, Prevacid, Nexium, Protonix, Aciphex and others — often are prescribed to patients who suffer from acid reflux, ulcers and heartburn. The treatments are popular because they quickly lessen symptoms. Until recently, medical experts also believed the medications’ toxicity level was low.

However, recent research has found that the medications cause a condition known as interstitial nephritis, which in turn can cause sudden, severe injury to the kidneys.

PPIs Block Acid — and Vital Minerals

Approximately 15 million Americans have been prescribed proton pump inhibitors, or PPIs. Patients also can get the medications without having a prescription from a medical professional.

The drugs work by blocking the buildup of acid in the stomach; the reduced acid prevents the formation of new ulcers and helps existing ulcers heal. However, the drugs also block the stomach from absorbing critical minerals. Serious side effects including heart attacks, bone fractures, and kidney problems can result.

The recent research, which appeared in the Journal of the American Society of Nephrology, looked at more than 173,000 individuals taking PPIs, along with more than 20,000 people taking an alternative medication. When the study authors reviewed data from the patients after five years, they found an alarming trend: The patients taking PPIs were at a 96-percent higher risk of kidney failure and a 28-percent higher risk of chronic kidney disease compared to the patients taking the alternative medication.

The study, along with previous research, suggests that doctors sometimes may be prescribing PPIs for patients who do not need them. Researchers note that individuals who receive a prescription for a PPI should take the drug sparingly and for the shortest possible period.

Development of Acute Kidney Injury

PrilosecUsing PPIs for extended periods — typically more than a year — increases the risk of problems with absorbing magnesium, calcium, and other important nutrients. Patients who take PPIs for long periods are at increased risk of kidney damage because the unabsorbed nutrients end up as waste materials. The kidneys remove waste from the body and assist in balancing water with minerals in the blood.

If you suffer acute kidney injury — also referred to as acute renal failure — your kidneys have suddenly stopped functioning. When kidneys stop working, waste products accumulate in the body and can cause potentially deadly problems. Older adults and individuals with long-term health problems — including high blood pressure, diabetes, existing kidney or liver disease, obesity or heart failure — are at increased risk of acute kidney injury.

Symptoms of Acute Kidney Injury

  • A small amount of urine or no urine present.
  • Diminished appetite.
  • Vomiting or nausea.
  • Swelling, particularly in the feet and legs.
  • Pain under the rib cage in the back.
  • Feelings of anxiety, restlessness or confusion.

Some individuals suffering from acute kidney injury may not experience symptoms. The condition is often misdiagnosed in patients already in the hospital for treatment of other medical problems.

Progression to Chronic Kidney Disease

Many patients experience a complete recovery from acute kidney injury after stopping the problematic medications. In some cases, however, the condition progresses to chronic kidney disease even after the medications have been stopped.

Some symptoms are similar to those for acute kidney injury:

  • Nausea and vomiting.
  • Decreased appetite.
  • Changes in urine volume.
  • Swelling of the ankles and feet.

Some additional symptoms may accompany chronic kidney disease:

  • Weakness, fatigue and trouble sleeping.
  • Muscle cramps and twitching.
  • A decrease in mental sharpness.
  • Frequent itching.
  • Hiccups.
  • Chest pain caused by possible buildup of fluid around the lining of the heart.
  • High blood pressure that is not easily controlled.
  • Shortness of breath caused by fluid buildup in the lungs.

Common symptoms of kidney disease also can be caused by other medical conditions, making diagnosis difficult in some cases. In addition, kidneys often compensate for loss of function, and symptoms may not be detectable until significant damage has occurred.

If you have symptoms of either acute or chronic kidney problems, see a doctor right away.

Treatment of Kidney Disease

Your general practitioner or a kidney specialist, known as a nephrologist, can treat your kidney problems. Depending on the cause of the problem, treatment methods can vary. If the problems are caused by proton pump inhibitors, your doctor likely will have you stop taking the medication.

In addition, your doctor will take measures to:

  • Stop the buildup of waste in your body. A possible treatment is dialysis, which uses a machine to remove wastes until your kidneys recover.
  • Minimize the risk of additional medical problems. Your physician may prescribe antibiotics to treat an infection, and she may recommend other medications to flush out excess fluid and keep your body’s mineral levels balanced.
  • Help you heal yourself. Your doctor may recommend a special diet that is easy on your kidneys, including limiting salt, potassium and phosphorus.

Can Kidney Injuries Cause Permanent Problems?

In about half of cases of kidney injury, medical professionals can repair the problems with several days or weeks of treatment. In these cases, patients recover enough kidney function to live normal lives.

But in other cases, kidney damage may be irreversible, resulting in chronic kidney disease. A small percentage of these patients need dialysis on a regular basis or even a kidney transplant. Seniors and individuals who suffer from other health problems have a higher risk of permanent kidney damage.

If you’ve used proton pump inhibitors like Prilosec, Prevacid, Nexium, Protonix, Aciphex and now suffer from kidney problems, it’s important to work with an attorney experienced in dangerous medications cases. Contact Meinhart, Smith, & Manning, PLLC, for a free consultation.

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