If a dose of Nexium (or Prevacid or Prilosec—really any proton pump inhibitor) precedes your five-alarm chili or extra spicy enchiladas, you may want to reexamine your game plan. New research shows that your go-to PPIs—the little pills that allow you to eat all the fiery foods and chocolate and caffeine you want—could have a serious effect on your kidneys. (Heal your whole body with the 12-day liver detox for total body health!)
The study, published in JAMA Internal Medicine, found that PPI use is associated with a higher risk of chronic kidney disease (CKD)—a condition that affects about 14% of adults in the US and is characterized by a gradual loss of kidney function.
Researchers examined the health records of 10,482 participants in the Artherosclerosis Risk in Communities (ARIC) study and found that the 322 people using PPIs had a nearly 12% risk of developing CKD over 10 years, while those who had never used the medication had an 8.5% risk. Another batch of records from 248,751 patients from the Geisinger Health System in Pennsylvania were also examined. Over the course of 10 years, the 16,900 patients using PPIs had a 15.5% risk of developing CKD, compared with a 14% risk in non-PPI using patients. And within each group that used the medication, twice-daily PPI use was associated with a higher risk of CKD than using the medication once daily.
Proton pump inhibitors were first introduced in 1990 with the promise of giving heartburn and indigestion the boot. Now, more than 15 years later, PPIs are one of the most commonly prescribed medications in the United States—despite studies that have linked PPIs to other health issues, such as hip fractures, pneumonia, and C. difficile infections, according to the JAMA Internal Medicine study. What’s more, an estimated 25 to 75% of all PPI prescriptions are unnecessary, and patients are known to take them beyond the recommended guidelines.
So what can PPI-taking, acid reflux sufferers do? Make sure you really need the meds in the first place, suggests Jamie Koufman, MD, founder of the Reflux Center and Voice Institute of New York. “If you’re only having occasional symptoms and you know they’re caused by a bad diet, you can probably stop your own acid reflux by rethinking when you eat and how you eat,” Koufman says. In her book, Dr. Koufman’s Acid Reflux Diet, she suggests eating more avocados, fish, and rice, while nixing “trigger” foods like onions, citrus, and chocolate.
And if you’ve been taking PPIs for a while, you may want to start considering your exit plan. “On average, patients shouldn’t be on a PPI for any longer than 1 to 6 months if they have severe acid reflux; they’re not for long-term use,” Koufman says. If you’re wary of PPIs but still want a medical fix for your chronic heartburn, ask your doctor about H2 blockers (like Zantac), which aren’t quite as strong as PPIs but offer fewer side effects, suggests Koufman.