Medications come with risks, and for years doctors have known people taking proton pump inhibitors (PPIs) for heartburn and acid reflux may be at risk for kidney damage. It was previously thought that the decline in kidney function is acute and transient. However, a new study raises concerns that this may not be the case. In some patients, kidney problems can develop slowly over time and result in chronic kidney disease.
"In most cases kidney damage is completely asymptomatic," says Laith Al-Rabadi, MBBS, a nephrologist with University of Utah Health Care. "Patients may only show symptoms at very advanced stages. These symptoms can be vague and include fatigue, low appetite, and nausea, or more florid like shortness of breath lower extremity swelling and confusion."
The kidney has small filters "glomeruli" that filter the toxins from the blood. PPIs cause inflammation of the tissue between those filters with subsequent damage and scarring over time. The impacts of the damage depend on how early it's caught. "The acute inflammatory component can be usually revered with stopping the medication," says Al-Rabadi. "Unfortunately, we can't replace the scarred part and chronic damage of the kidney. We preserve whatever left of the remaining kidney function with the goal of avoiding the need for dialysis."
Those most at risk for kidney damage from PPIs are people taking them for an extended period of time. Most brands of PPIs instruct patients to take one pill a day for a period of 14 days. However, some users may begin taking it regularly - making it a part of their daily routine.
The best way to handle heartburn, and keep your kidneys healthy, is to use the medication for a short time as directed. You can also reduce the risk of damaging your kidneys by changing your behavior in other ways. "Avoid taking other medications that can cause tissue damage like nonsteroidal anti-inflammatory drugs and drinking decent amount of water." says Al-Rabadi. "Also, control your blood pressure, watch your sugar intake, and generally follow a healthy lifestyle."