Did you know this version of Internet Explorer is out of date?

To get the latest experience from our website, please upgrade your browser.

Have a drug or medical device concern?

call 877-630-1205

Recent Studies Link Heartburn Medicine and Increased Risk of Kidney Damage

Dana Jerusalmi

Last updated: November 9, 2016 8:33 pm

On This Page

Proton pump inhibitors (PPI) are a commonly used type of medication for the treatment of heartburn, ulcers, gastroesophageal reflux disease (GERD) and acid reflux. 1 Since they entered the US market almost 40 years ago, these heartburn drugs have been associated with health complications such as hip fracture and community-acquired pneumonia. 2 Recent studies have also linked the use of heartburn medicine to other serious, potentially fatal conditions such as:

  • Kidney failure 3
  • Chronic kidney disease
  • Acute interstitial nephritis 4
  • End-stage renal disease 5

The results of studies on PPIs linking these drugs to kidney failure and other side effects may have a tremendous impact on public health, given the widespread use of these medications.

Common Drugs Linked to Kidney Failure

PPIs are sold under both generic and brand names, by prescription and over-the-counter (OTC). They decrease the production of acid in the stomach. This type of heartburn medicine is one of the highest-selling types of drugs in the United States. 6 Examples of frequently used PPIs include:

  • Esomeprazole, often sold as Nexium
  • Omeprazole, often sold as Prilosec
  • Lansoprazole, often sold as Prevacid
  • Rabeprazole, often sold as AcipHex
  • Pantoprazole, often sold as Protonix
  • Dexlansoprazole, often sold as Dexilant
  • Omeprazole with sodium bicarbonate, often sold as Zegerid 7

PPIs and Chronic Kidney Disease  

A February 2016 article in the Journal of the American Medical Association (JAMA) found that the use of PPIs is linked to a 50 percent higher risk of developing chronic kidney disease. 8

Chronic kidney disease is a serious condition affecting 13.6 percent of American adults 9 that is correlated with a significantly heightened risk of cardiac problems and even death. 10

Symptoms of chronic kidney disease may include:

  • Fatigue
  • Headache
  • Itching and/or dry skin
  • Weight loss
  • Loss of appetite/nausea 11

Heartburn Drugs and Increased Risk of End-stage Renal Disease

End-stage renal disease (ESRD), also known as end-state kidney disease or end-stage renal failure, is the final and most severe stage of CKD. ESRD occurs when your kidneys are no longer able to sustain your body’s needs. In the April 2016 volume of the journal Medicine, the authors reported an almost doubling of the risk of ESRD amongst PPI users. 12 In order to treat ESRD, you may need dialysis or a kidney transplant. Common symptoms of ESRD are the same as those for CKD, but also may include:

  • Bone pain
  • Swelling of the hands and feet, known as edema
  • Drowsiness and confusion
  • Muscle twitching or cramps
  • Excessive thirst 13

PPIs and Acute Interstitial Nephritis 

A 2015 study in CMAJ Open found that patients who took PPIs were three times as likely to develop acute interstitial nephritis (AIN) as those who did not take PPIs. 14 AIN occurs when the area between the kidney tubules become inflamed. It can lead to mild kidney problems, but can also lead to life-threatening conditions such as acute kidney failure.

Symptoms of AIN include:

  • Increased or decreased urine output
  • Nausea and vomiting
  • Blood in urine
  • Fever
  • Mental status changes such as confusion or drowsiness
  • Weight gain
  • Rash
  • Swelling of any area of the body 15

PPIs and Acute Kidney Injury

The same 2015 study in CMAJ Open that found increased risk of AIN in those taking PPIs also found that people taking PPIs were three times as likely to be diagnosed with AIN, during the time the study examined when compared with people not taking PPIs. 16

AKI, also referred to as acute renal failure or acute kidney failure, occurs when your kidneys suddenly lose their ability to filter out waste from your blood. This loss of function develops over the course of hours or days and may be fatal. 17

Symptoms may include:

  • Decreased urine output
  • Fluid retention, leading to swelling in legs, ankles or feet
  • Drowsiness and fatigue
  • Shortness of breath
  • Confusion
  • Nausea
  • Seizures or coma
  • Chest pain or pressure 18

Other Side Effects of PPIs

The U.S. Food and Drug Administration (FDA) has alerted the public about other possible side effects of these heartburn drugs, including:

  • Clostridium difficile–associated diarrhea 19
  • Hypomagnesemia (low serum magnesium levels), when prescription PPIs are taken for extended periods of time 20
  • Possible increased risk of osteoporosis and fracture when prescription PPIs are taken for extended periods of time and/or at a high doses 21
  1. http://www.cnn.com/2016/04/14/health/proton-pump-inhibitors-kidney-failure/

  2. http://archinte.jamanetwork.com/article.aspx?articleid=2481157 

  3. http://www.cnn.com/2016/04/14/health/proton-pump-inhibitors-kidney-failure/ 

  4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571830/ 

  5. http://journals.lww.com/md-journal/Fulltext/2016/04120/Association_Between_the_Use_of_Proton_Pump.59.aspx 

  6. http://www.healthline.com/health/consumer-reports-proton-pump-inhibitors 

  7. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000381.htm 

  8. http://archinte.jamanetwork.com/article.aspx?articleid=2481157 

  9. https://www.usrds.org/2014/view/Default.aspx 

  10. http://www.nejm.org/doi/full/10.1056/NEJMoa041031 

  11. https://www.nlm.nih.gov/medlineplus/ency/article/000471.htm 

  12. http://journals.lww.com/md-journal/Fulltext/2016/04120/Association_Between_the_Use_of_Proton_Pump.59.aspx 

  13. https://www.nlm.nih.gov/medlineplus/ency/article/000500.htm 

  14. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571830/ 

  15. https://www.nlm.nih.gov/medlineplus/ency/article/000464.htm 

  16. http://cmajopen.ca/content/3/2/E166.full 

  17. https://www.kidney.org/atoz/content/AcuteKidneyInjury 

  18. http://www.mayoclinic.org/diseases-conditions/kidney-failure/basics/symptoms/con-20024029 

  19. http://www.fda.gov/Drugs/DrugSafety/ucm290510.htm 

  20. http://www.fda.gov/Drugs/DrugSafety/ucm245011.htm 

  21. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm213206.htm