The Risks of Relief

A recent study by University at Buffalo researchers links one of the most commonly prescribed medications in the U.S to chronic kidney disease and acute kidney injury.

The finding adds to a list of concerning side effects associated with the group of medications known as proton pump inhibitors, or PPIs, which are frequently prescribed to treat heartburn, acid reflux and ulcers.

PPIs, sold under brand names such as Prevacid, Prilosec, Protonix, Vimovo, Aciphex and others, are prescribed to well over a million people in the U.S., who spend an estimated $14 billion on them annually. What’s more: Up to 70 percent of patients use these medications unnecessarily, since many conditions require only short-term treatment with PPIs.

Those are troubling numbers, as these drugs come with some concerning side effects. While kidney damage was suspected to be among them, there just wasn’t enough conclusive evidence documenting the link. Until now.

Using data gathered from medical insurance and prescription claims, David Jacobs, assistant professor of pharmacy practice at UB, led a research team that examined the medical histories of more than 190,000 adult patients. Kidney health was compared between patients who underwent PPI therapy and those who were unexposed.

The study, one of the first large, long-term studies to examine the effects of PPIs on kidney function, showed PPI use to increase the risk of chronic kidney disease by 20% and the risk of acute kidney injury by four times. The risks were highest among people 65 and older.

Jacobs, whose research team is focused on improving the care and medication management of older adults in the United States, says education and de-prescribing initiatives are needed to raise awareness among health care providers, most of whom still consider these drugs to be safe. “PPIs are a commonly overprescribed medication,” he says, “and our research is beginning to show the negative effects of inappropriate prescribing.”