If you pop heartburn meds like they're dinner mints, you may be doing more to your body than just quieting chest pain: Proton pump inhibitors (PPIs), one of the most common prescriptions for managing acid reflux, have been linked to serious — and sudden — kidney damage, according to a new study from Washington University School of Medicine in St. Louis.
In the February 2017 study published in Kidney International, researchers found that more than half of 125,000 U.S. patients who took PPIs developed chronic kidney disease (CKD) without showing any acute kidney problems beforehand.
It's that lack-of-advance-warning part that's both new and the most worrisome: Traditionally, when you take PPIs (brand names Losec, Nexium, and Prevacid), your doc monitors for acute kidney injury, which is kind of the flash-flood version of CKD — a sudden episode of kidney failure or damage that occurs within a few hours or days of the trigger. If you exhibit early warning signs — decreased urination, nausea, or swelling in the legs, ankles, or feet — your doc would take you off the drug that may have triggered the problems.
Sounds like a smooth plan, right? This latest study, though, suggests PPIs users might not actually present the flash-flood-like warning signs before going into full-blown CKD — they essentially skip the rainstorm and are dropped straight into the damaging flood.
A Long and Problematic History
It's no secret that PPIs are linked to kidney damage. A November 2015 study out of John Hopkins University found people who took PPIs were 20 to 50 percent more likely to develop CKD than those who didn't, and another November 2015 study from State University of New York at Buffalo found 25 percent of patients who developed CKD used PPIs.
There are three main types of heartburn medications, and it's certainly not just PPIs that cause damage. But the new study did find that people using PPIs were about 20 percent more likely to develop CKD compared to those taking another type of stomach acid-reducing med known as H2s. (Zantac and Pepcid fall into this category.)
And it's not just your kidneys that are at risk here. A January 2017 study linked moms-to-be taking any kind of heartburn med (that's PPIs, H2s, or antacids) with an increased risk of their children developing asthma. Meanwhile, a February 2016 study found that folks over 75 years old who took PPIs were 44 percent more likely to develop dementia compared to those not on the heartburn medication. To top it off, a June 2015 study found long-term PPI users had a higher risk for cardiovascular disease compared to H2 users.
Again, all these studies prove a link between the medication and disease, not cause and effect. But doctors do recommend first trying to avoid the cause of heartburn (that includes spicy food, alcohol, citrus, coffee, tomatoes, peppermint), and then if you still need an acid reducer, talk to your doc about alternatives to PPIs, like H2s.