The relationship between proton pump inhibitors and renal disease

Morschel, Carine Franco; Mafra, Denise; Eduardo, José

doi:10.1590/2175-8239-jbn-2018-0021

Cited by 25 publications

(18 citation statements)

References 42 publications

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“…[ 24 , 30 , 31 ] We suggest that renal biopsy may represent a useful technique for characterizing the pathological changes underlying the progression of AIN to chronic renal injury. [ 30 , 32 ] Furthermore, the use of renal biopsy could help in increasing our understanding of the factors influencing the prognosis of renal disease caused by long-term PPI use and the ability of renal function to recover after discontinuation of the drug.…”

Section: Discussionmentioning

confidence: 99%

Drug rash with eosinophilia and systemic symptoms and severe renal injury induced by proton pump inhibitor therapy

He¹,

Ying²,

Fei³

et al. 2020

Medicine

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Introduction: Proton pump inhibitors (PPIs) are widely prescribed and generally well tolerated but can rarely cause severe allergic reactions, such as drug rash with eosinophilia and systemic symptoms (DRESS). We report a case of DRESS and renal injury induced by PPIs, and describe the therapeutic process. Patient concerns: The patient was a 66-year-old female who complained of fever, pruritus, desquamation, erythema multiforme, and anuria caused by omeprazole taken for 2 weeks to treat abdominal distention. Diagnosis: The clinical history revealed a similar episode of PPI-induced fever, eosinophilia, and acute kidney injury more than 1 year ago. The present laboratory tests revealed eosinophilia and oliguric renal failure. The renal biopsy was performed subsequently and proved the diagnosis of PPI-induced DRESS. Interventions: After the suspected diagnosis of PPI-induced DRESS, omeprazole was discontinued and methylprednisolone infusion (40 mg qd) was initiated. Because of oliguric renal failure, the patient received intermittent hemodialysis. Outcomes: The patient initially responded to omeprazole discontinuation, hemodialysis, and glucocorticoids but later died from severe infection during the tapering of glucocorticoid therapy. Conclusion: Clinicians should remain on high alert for potential life-threatening complications when prescribing PPIs. If unexplained renal injury develops in a patient taking a PPI, renal biopsy may help in identifying the pathogenesis and might facilitate timely intervention.

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Section: Discussionmentioning

confidence: 99%

Drug rash with eosinophilia and systemic symptoms and severe renal injury induced by proton pump inhibitor therapy

He¹,

Ying²,

Fei³

et al. 2020

Medicine

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“…Among its adverse effects related to kidney injury, what stands out is acute interstitial nephritis. This inflammation is associated with the accumulation of the drug in the interstitial tubules, which leads to an immune response 47 .…”

Section: Drugs That Act On the Gastrointestinal Tractmentioning

confidence: 99%

Nefrotoxicidade e alterações de exames laboratoriais por fármacos: revisão da literatura

Mello

Rocha

Oliveira

et al. 2021

Rev. Med. (São Paulo)

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O uso de substâncias nefrotóxicas, hipertensão arterial, diabetes mellitus, dentre outros, podem lesionar os rins e comprometer o seu funcionamento. A presença de lesão nos rins e a função renal podem ser avaliadas por meio de diversos marcadores bioquímicos, tais como creatinina sérica, ureia sérica, cistatina C sérica, proteinúria, taxa de filtração glomerular e eletrólitos. Diversos fármacos podem alterar os resultados dos exames laboratoriais de avaliação dos rins por mecanismos in vivo ou in vitro, sendo importante o conhecimento de quais medicamentos causam este tipo de interferência. Esta revisão da literatura teve como objetivo apresentar os principais fármacos que podem gerar tais interferências nos exames de avaliação dos rins e seus principais mecanismos. Vários fármacos considerados nefrotóxicos podem promover aumento dos níveis séricos de creatinina e ureia, diminuição da taxa de filtração glomerular ou proteinúria, sendo importante o monitoramento da função renal dos pacientes que os utilizam. Além disso, o uso de alguns destes fármacos deve ser evitado por pacientes que possuem doença renal crônica ou deve ser feito o ajuste adequado da dose caso oseu uso seja imprescindível. Alguns fármacos podem inibir asecreção renal da creatinina, aumentando seus níveis séricos, naausência de alteração da função renal. Outros podem alterar osníveis séricos de eletrólitos ou a densidade urinária, ou ainda interferir na dosagem de outros marcadores de avaliação da função dos túbulos renais. É fundamental o conhecimento dos fármacos que interferem nos exames de avaliação dos rins pelos profissionais da área da saúde para que estes possam interpretar corretamente os exames laboratoriais, resultando em diagnóstico e terapia adequada.

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“…It is cited higher incidence in the (54,55) elderly , increased risk of incomplete (15,17,30,56) recovery of renal function and progression (57) t o c h r o n i c i t y , e v e n w i t h p r o m p t ( 5 4 ) corticosteroid treatment applied after biopsy confirmation. Eosinophilia is usually seen , but other (58) s p e c i fi c m a n i f e s t a t i o n s o f AT I N a re inconsistent , so many cases are classified as (59) AKI of unknown cause until a biopsy is obtained. In some non-Caucasian races, a genetic predisposition for PPIs-induced ATIN has been described ; because PPIs are (60) metabolized by the cytochrome P450 enzyme system, patients with CYT P450 genetic polymorphism appear to be at risk for ATIN due to the interstitial accumulation of PPIs and/or their metabolites where they elicit an immune-mediated inflammatory response .…”

Section: Particular Forms Of Di-atin Atin To Proton Pump Inhibitorsmentioning

confidence: 99%

Drug-Induced Acute Tubulointerstitial Nephritis

Rădulescu

2020

Internal Medicine

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Nowadays, incidence of drug-induced acute tubulointerstitial nephritis is on the rise due to increased access of the patients to a variety of both prescribed and over-the-counter drugs. Acute kidney injury and hypersensitivity manifestations are the main features of acute tubulointerstitial nephritis.Classically considered reversible after prompt withdrawal of the offending medication, recent decades revealed potential for evolution to chronic kidney disease. This article presents the challenges in the diagnosis and treatment and also evolutive features of allergic acute tubulointerstitial nephritis induced by drugs.

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The relationship between proton pump inhibitors and renal disease

Cited by 25 publications

References 42 publications

Drug rash with eosinophilia and systemic symptoms and severe renal injury induced by proton pump inhibitor therapy

Drug rash with eosinophilia and systemic symptoms and severe renal injury induced by proton pump inhibitor therapy

Nefrotoxicidade e alterações de exames laboratoriais por fármacos: revisão da literatura

Drug-Induced Acute Tubulointerstitial Nephritis

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