Proton pump inhibitors (PPIs) are among the most commonly prescribed and used drugs worldwide, and have been linked to acute interstitial nephritis. It has been estimated that between 25% and 70% of these prescriptions have no appropriate indication, and the duration of use extends well beyond recommended guidelines. The object of this study was to quantify the association between PPI use and incident kidney disease (CKD) in the general population, and as a secondary outcome, to evaluate the link between PPI use and acute kidney injury (AKI). Using data collected from the Atherosclerosis Risk In Communities (ARIC) study, there were 56 incident CKD events among the 322 baseline PPI users (14.2 per thousand person-years), and 1382 events among the 10,160 baseline nonusers (10.7 per 1000 person-years). An even stronger association was seen between PPI use and AKI. In the replication cohort, PPI use was significantly associated with incident CKD in unadjusted analyses, in adjusted analyses, and when estimated using a time-varying ever-use model. Similar associations were seen with incident AKI, with PPI use resulting in a higher risk. Researchers concluded that PPI use is an independent risk factor for CKD and AKI.
Lazarus B, et al. Proton Pump Inhibitor use and the Risk of Chronic Kidney Disease. JAMA Intern Med. 2016;176(2):238-246.