Proton Pump Inhibitors and Kidney Disease
Last fall I wrote a blog summarizing the potential effects of proton pump inhibitors (PPI) and cognitive decline.
Gastric Reflux is Super Common
About 40% of the adult population in the U.S. reports some level of acid reflux. This explains why over the counter and prescription versions of omeprazole, lansoprazole, esomeprazole, rabeprazole or dexlansoprazole and others are so very common. As a category they are number three in popularity only behind psychotropic and statin medications. In dollars the works out to about $10 billion a year.
Cognitive Decline and Kidney Problems Are Important Risks
We are used to hearing about serious problems with prescription medications and PPI's are not an exception. Besides the increase in cognitive decline, problems are being reported for kidney disease too. A new article published in JAMA Internal Medicine based on two population-based studies. The studies are observational meaning that it is difficult to draw strict causal relationships but the studies looked at fairly large sample groups (10,000 in one and 250,000 in the other) so this data cannot be ignored.
PPI Associated with Higher Risk of Kidney Disease
In the group not using PPI's, the rate of developing CKD (chronic kidney disease) was about 8.5%. For those using PPI's, the rate increased to 11.8%. In another group, the non PPI CKD rate was 13.9% vs 15.6% for the PPI using group.
A disturbing part of this trend is that the kidney disease seems to be silent until it becomes a real problem. In other words, a person doesn't get a lot of notice that kidney problems are imminent. It would be nice to have a heads up
The researchers suggested checking to verify that treatment is needed at all. Often a person is given a PPI in the hospital to help counteract the temporary meds and then the prescription is automatically filled forever.
Medical Alternatives Are Available
For those needing treatment for gastric reflux & heartburn, alternative to PPI's like histamine-2 receptor antagonist (H2 antagonists) meds are available. Those drugs do not seem to have the same correlations to kidney disease as the PPI's. H2 antagonists are available as OTC (over the counter) and as prescription drugs. There are lots of them but you might recognize names like Pepcid, Tagamet or Zantac.
Since this is health blog focusing on natural things you can do, I can't leave you with drug recommendations. The first task is to limit the problem as much as possible.
Learn About Histamine Producing Foods
First thing I can do is refer you to a recent blog discussing histamine intolerance. (link coming) If you are experiencing acid reflux, you should begin by learning which foods in this group are not well tolerated by your body. Each person is different and you will most likely find one or two foods on the list that your body doesn't like and advises you with acid reflux symptoms. For some it might be almonds and cheese and in another it might be the tomatoes and avocados. It should only take a few weeks to sort this out as acid reflux tends to manifest with a few hours and then builds and builds in a not so subtle fashion.
I strongly recommend that you begin here to find a solution to your acid reflux. It has been the experience of many that histamine reducing supplements and digestive enzymes can be a help on a scale of 1-10, these are probably a 2 whereas finding the offending food is a 9 or 10.
Visit A Dialysis Clinic
If you still aren't convinced that you want to work to control your diet to help your acid reflux so you don't need the meds that could damage your kidneys, drop in to a local dialysis center and talk with some of the staff and patients. See if you are Ok with that being your future.
Keep in mind that acid reducers don't just affect the stomach but affect proton pumps around the body.