Millions of people take medicines called proton pump inhibitors, or PPIs, to relieve heartburn, acid reflux, and gastroesophageal reflux disease (GERD).
These medicines reduce the amount of acid made by the stomach and can quickly ease painful symptoms. Some of the best-known brands include Prilosec, Nexium, and Prevacid, and many are available without a prescription.
Although PPIs are very effective, scientists are continuing to study their long-term safety. A new study from the University of California San Diego suggests that using these medicines for a long time may increase the risk of serious kidney problems. The findings were published in the journal Scientific Reports.
For the study, researchers examined information from the U.S. Food and Drug Administration Adverse Event Reporting System, a large database that collects reports of possible medicine side effects. The database contains more than 10 million reports from patients and healthcare professionals.
To reduce the influence of other medicines, the researchers focused on about 43,000 people who were taking only a PPI. They compared them with around 8,000 people who were taking H2 blockers, another type of acid-reducing medicine that includes drugs such as Pepcid and Zantac.
The results showed that people taking PPIs were much more likely to report kidney problems than those taking H2 blockers.
They were more than 28 times more likely to report chronic kidney disease, more than four times more likely to develop acute kidney injury, more than 35 times more likely to report end-stage kidney failure, and about eight times more likely to experience other forms of kidney damage.
The researchers also found that PPI users were more likely to have problems with electrolyte levels. Electrolytes are important minerals that help control the heartbeat, muscle function, and many other body processes. The increased risk appeared with all five PPI medicines studied, suggesting the problem may be linked to this whole group of drugs rather than one specific brand.
Kidney disease can become serious if it is not detected early. Chronic kidney disease often develops slowly and may not cause noticeable symptoms until much of the kidney’s function has been lost. Acute kidney injury develops much more quickly and may require urgent medical treatment, while end-stage kidney failure often requires dialysis or a kidney transplant.
The researchers stress that these findings do not mean everyone should stop taking PPIs. For many people, these medicines provide important relief and prevent complications from severe acid reflux. However, the study suggests that patients and doctors should carefully consider whether long-term treatment is truly necessary.
If PPIs are needed for a long period, doctors may choose to monitor kidney function, especially in people who already have conditions such as diabetes or high blood pressure that increase the risk of kidney disease. Using the lowest effective dose for the shortest possible time may also reduce potential risks.
Many people may also benefit from lifestyle changes that reduce acid reflux naturally. Eating smaller meals, avoiding foods that trigger symptoms, maintaining a healthy weight, avoiding meals close to bedtime, and quitting smoking can all help reduce the need for medication in some cases.
This is not the first study to question the long-term safety of PPIs. Earlier research from the same University of California San Diego team suggested these medicines may also be linked to liver problems.
The latest study, led by Ruben Abagyan, reminds both patients and healthcare providers that even common medicines can have important side effects when used for long periods. People should always discuss the benefits and risks of long-term treatment with their healthcare provider before making any changes to their medication.
If you care about kidney health, please read studies about how to protect your kidneys from diabetes, and drinking coffee could help reduce risk of kidney injury.
For more health information, please see recent studies about foods that may prevent recurrence of kidney stones, and eating nuts linked to lower risk of chronic kidney disease and death.
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