Proton pump inhibitors and acute interstitial nephritis

Abstract

Proton pump inhibitors are an important iatrogenic cause of acute kidney injury

Proton pump inhibitors and the risk of acute kidney injury in older patients: a population-based cohort study

“…4 Evidence for this association is limited to anecdotal reports, case series and 3 observational studies, one of which was based on only 5 cases of acute interstitial nephritis and one which examined the risk of acute kidney injury only. [4][5][6][7][8][9] Importantly, because classic systemic features of drug-induced acute interstitial nephritis are often absent in PPI-associated cases, the causal role of these drugs may be overlooked.…”

Proton pump inhibitors: are they safe on kidneys: a histopathological study

“…1,12,19 It is possible to infer that if we would have stopped the drug at the first confirmed sign of deranged renal function, we could have seen reversal of the damage and confirmation of the postulate. 1,7 However since our aim was to first asses that the damage is produced and it is like AIN by HPE methodology, we accept this limitation of the study.…”

“…1 The recognition and diagnosis of AIN is vitally important because the condition is potentially reversible. 1,7 Most patient diagnosed with AIN recover, however some patients retain a degree of renal impairment and some even progress to end stage chronic kidney disease (CKD). 1 Early detection of this rare adverse reaction and immediate discontinuation of the offending agent may potentially prevent renal failure.…”

Analysis of Gastrointestinal Prophylaxis in Patients Receiving Dual Antiplatelet Therapy with Aspirin and Clopidogrel

“…4 Alternatively, the inappropriate use of GI prophylaxis in patients without an indication could be subjecting patients to a potential increased risk of adverse PPI outcomes as noted in previous studies. [7][8][9][10][11][12][13][14] Inappropriate PPI prescribing is also associated with an increased cost burden to the health care system. 29 In patients who received no prophylaxis at discharge when therapy was indicated, advanced age appears to be the risk factor most commonly overlooked or disregarded.…”

“…6 This consensus document recommended gastroprotection with a PPI for all patients receiving DAPT. However, PPI use has been associated with multiple adverse outcomes, including an increased incidence of Clostridium difficile infection (CDI), 7,8,9 fractures, 10,11 acute interstitial nephritis, 12 hypomagnesemia, 13 and pneumonia.…”