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New research has found that proton pump inhibitors (PPIs) like Nexium, Prilosec, and Aciphex, may increase the risk of kidney impairment and kidney failure. The most recent study on the issue, published in April 2016, found similar results, and cautions that long-term use of these drugs can be even worse for patients.

PPIs are a newer class of drugs that can block the production of stomach acid. They neutralize enzymes that are involved in the process, thereby reducing stomach acid and easing symptoms of conditions like acid reflux, gastroesophageal reflux disease (GERD), and stomach ulcers.

Regular use of these drugs has been linked to various health risks, including bone fractures, heart disease, hypomagnesemia (low levels of magnesium), and a rebound or dependency effect.

Studies Link PPI Use with Chronic Kidney Disease

For this most recent study, researchers used the national Veterans Administration databases to identify over 173,000 patients who were new users of a PPI, and over 20,000 who used another type of antacid drug called an H2 blocker. Both of these drugs are used to treat the same health conditions.

The researchers then followed the data for five years, and found the following results:

• Those who were prescribed a PPI were 28 percent more likely to develop chronic kidney disease (CKD) than those taking H2 blockers.
• Patients who had received a PPI were also 53 percent more likely to experience a doubling of serum creatinine—an indicator of impaired kidney function.
• Those who had taken a PPI were 96 percent more likely to progress to end-stage renal disease (ESRD) than those taking an H2 blocker.
• The longer the patients took the PPIs, the greater their risk of kidney problems.

These results confirmed those found in an earlier study of over 10,000 patients which found that PPI users had a 35 percent increased risk of CKD, compared to those who had never used PPIs.

Doctors Recommend More Careful Use of PPIs

Indeed, medical professionals are now starting to urge patients who use PPIs for occasional heartburn or stomach acid problems to avoid or limit PPI use, and that consumers should choose lifestyle changes and H2 blockers (like Zantac) when possible.

Due to their risks, PPIs should be reserved for more serious acid reflux disease, when the esophagus is inflamed or when an ulcer is present. In these cases, a PPI can help reduce inflammation and allow for healing, but again, long-term use should be discouraged unless necessary.

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