Concomitant acute interstitial nephritis and autoimmune hemolytic anemia induced by omeprazole

Sharma, Nandita; Ip, Randy; Hadid, Tarik

doi:10.1002/ccr3.2661

Cited by 2 publications

(2 citation statements)

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“…12,13 Chronic kidney disease and acute interstitial nephritis have also been linked to various PPIs, although these adverse effects are relatively rare but increasing due to the growing use of these medications. 14,15 Suppression of acid secretion can alter the bacterial intestinal flora, leading to C. difficile infections and respiratory infections due to microorganisms aspirated into the lungs, causing pneumonia. [16][17][18][19] Deprescribing PPIs has been studied, and systematic reviews have failed to demonstrate the clinical harm associated with this practice.…”

Section: Introductionmentioning

confidence: 99%

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Proton Pump Inhibitor Deprescription Prospective Study in Patients Without Indication: Are There Differences in Proportion of Restarts According to Withdrawal Strategy?

Barraquer Comes,

Roy Millán

2023

Journal of Pharmacy Technology

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Background: The increasing utilization of proton pump inhibitors (PPIs) in patients without clear medical indications has raised concerns regarding potential risks, highlighting the importance of deprescription. However, comparative analyses of withdrawal strategies (abrupt vs gradual) in this context remain scarce or of low quality. Aim: This study aimed to evaluate the success rate of deprescribing PPIs in hospitalized patients without a documented indication and compare the proportion of treatment restarts based on withdrawal strategy. Method: An uncontrolled, open-label prospective observational study was conducted on patients receiving PPI treatment during hospital admission between May 2017 and July 2018. Deprescription was recommended for patients without a clear indication. Follow-up continued until discharge, with monitoring for rebound symptoms. The percentage of restarts based on the withdrawal strategy was compared using the chi-square test. Results: A total of 402 patients were reviewed, among whom 27% lacked a medical indication (mean age > 60 years, polymedicated), while 70% were prescribed PPIs electronically. Deprescription was performed in 49% of patients, with 64% undergoing abrupt withdrawal. Rebound symptoms led to treatment restart in 15% of cases. However, the chi-square test revealed no significant differences in restart proportions between the abrupt and gradual withdrawal groups ( P = 0.365). Conclusion: Deprescribing PPIs is deemed safe, particularly for polymedicated geriatric patients, as it leads to a low percentage of restarts regardless of the chosen withdrawal strategy. However, the high percentage of PPI prescription without a clear indication underlines the need for periodic reassessment to avoid unnecessary risks and overuse.

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