- A new study shows that older patients who take proton pump inhibitors (PPIs) for relief of heartburn and acid reflux are twice as likely to be hospitalized for kidney failure.
- The study, which was published recently in the Canadian Medical Association Journal, involved almost 600,000 patients aged 66 and older, half of whom took PPIs and half of whom did not during the study period, which lasted from 2002 to 2011.
- Overall, PPI patients had an acute kidney failure-related hospitalization rate of 13.49 per 1,000 person-years, compared with 5.46 per 1,000 in non-PPI patients.
Although the total number of cases of acute kidney failure in this study was less than 2,000, this trial was sufficiently powered to detect increased risk. The overall response to the study, however, has not been to automatically discontinue prescribing PPIs to elderly patients, who need them and benefit from them. Of course, the decision-making process for patients with medical conditions, which place them at increased risk of kidney failure, merit special consideration.
On the other side of this issue is the patients who benefit from PPIs and actually enjoy a decreased risk of morbidity and mortality as a result of taking them. In fact, according to George Sachs, a professor of UCLA, was quoted by Reuters as follows: "For patients with gastroesophageal reflux disease, or GERD, the drugs can prevent the development of life-threatening esophageal cancer."
In the final analysis, even if physicians don't view the increased risk as an absolute clincal game-changer, having additional safety information about such a popular class of drugs can help inform medical decision-making.