It caught my attention some months ago, when reading an article from PSIP (Patient Safety through Improved Medication Practices), that they had listed one of their ADE triggers as the use of proton pump inhibitors (PPIs) being correlated with renal failure. Fast forward to today when I ran into a colleague at a medical lecture on care transitions, that he happened to tell me of an “ADE story” of a wife of a dear friend who experienced renal failure that was thought to be caused by a PPI. After hearing his story I then acknowledged him, knowing that people don’t like to be marginalized by suggesting their ADE is not real. I told him of my recollection of having seen evidence of PPIs causing renal failure. This should then be a predictable ADE, when we know it can occur, we can monitor kidney function and mitigate a possibly serious ADE. Yes, this one is relevant and should be included in your knowledge base. It may not be common among PPI users, but it pays to know that it can occur so you don’t bark up the wrong tree wondering why someones kidney function is declining.
The issue of renal failure from PPIs was confirmed in one study where 296 biopsies were studied, and of 24 cases of acute interstitial nephritis, 14 were drug-induced and eight of those were from PPIs. Another study which reviewed 210 kidney biopsies found eight cases in which PPIs were the cause. Although this is a rare adverse drug reaction, based on the evidence I suggest we look closer at the chronic use of these medications and flag them as a risk factor when performing our medication reviews, all in an attempt to reduce unnecessary harm from the misuse of medications. Who thinks of PPIs causing renal failure? This one is well disguised.
Here are three links that speak to the incidence: