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 21 February 2018

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News

Proton pump inhibitors and acute interstitial nephritis

Increasingly widespread use of PPIs will result in increased incidents of PPI-induced acute interstitial nephritis, find researchers in the latest issue of Clinical Gastroenterology and Hepatology.

News image

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Proton pump inhibitors (PPIs) are generally well-tolerated drugs. However, case reports and a recent case series have implicated them in acute interstitial nephritis and renal failure.

In this study, researchers from Australia investigated the spread of PPI-induced acute interstitial nephritis.

The team also examined which PPIs are implicated and whether PPI-induced acute interstitial nephritis is a class effect.

They conducted a retrospective review of potential cases and reviewed registry data from the Therapeutic Goods Administration of Australia.

The researchers identified 18 cases of biopsy-proven PPI-induced acute interstitial nephritis causing acute renal failure.

All commercially available PPIs were implicated.
Clinical Gastroenterology and Hepatology

Using the registry data, they identified an additional 31 cases of “biopsy proven interstitial nephritis.”

Furthermore, they identified 10 cases of “suspected interstitial nephritis,” 20 cases of “unclassified acute renal failure,” and 26 cases of “renal impairment”.

The team determined that all 5 commercially available PPIs were implicated in the cases.

Dr Nimeshan Geevasinga's team concluded, "With the ever more widespread use of this class of medications, PPI-induced acute interstitial nephritis is likely to become more frequent".

"There is now evidence to incriminate all the commercially available PPIs, suggesting there is a class effect".

"Failure to recognize this entity might have catastrophic long-term consequences including chronic kidney disease".

"Increased awareness might facilitate more rapid diagnosis and management of this potentially reversible condition".

Clin Gastroenterol Hepatol 2006; 4(5): 597-604
24 May 2006

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