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Headlines in Health: PPI's and Kidney Disease

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Drs. Vaughan and Carlson discuss the topic of PPIs and Kidney disease. Are Prilosec, Nexium and other PPIs safe and what is the best way to use these medicines in consultation with your doctor? PPI Kidney Injury G:welcome and introduction of Dr. Mark Vaughan of the Auburn Medical Group YouTube Channel M: thanks Dr. Carlson. It's an honor to be on your YouTube channel. I look forward to the conversation we will share and the opportunity it presents for you, our respective subscribers, to learn about The facts behind the sensational headlines. G: there has been quite a bit of media coverage of an article in the February edition of the Journal of the American medical Association internal medicine. It is a study which suggests that a common drug to both of our practices can cause injury to patients’ kidneys. The class of drug is called proton pump inhibitors. Most of you will recognize the names Prilosec and Nexium as popular name brands from this class. Their function is to turn off the acid pump in the stomach to decrease injury from acid inside the digestive tract. These medicines are usually prescribed for patients who have either short-term or long-term overproduction of acid resulting in symptoms ranging from heartburn to stomach ulcers. Now that they are available over-the-counter without a prescription they are used by many patients without any consultation with a physician. M: The article reports on a small study done on data collected during the atherosclerosis risk in communities study which studied over 10 thousand subjects. The results were then replicated by analyzing records of over 240 thousand individuals. They found that patients who used proton pump inhibitor drugs had a significantly higher incidence of chronic kidney disease on a blood test compared to people who did not use these drugs. They also found that there was a significant increase in kidney disease when compared to people who used H2 antagonist drugs. The cutoff they used to delineate between people with and without chronic kidney disease was based on a lab value found on a blood test. There was no requirement that the patients have any symptoms or other noticeable effect on their health to be labeled as having kidney disease. It is expected that the vast majority of these patients will never suffer any significant ill effects apart from this number found on a lab test. G: but that does not give us license to take these drugs willy-nilly. They should still only be used when there is significant benefit over alternative treatments. The simplest is through diet. Many of the problems which respond to this type of medication can be better treated by reducing intake Of fatty foods, alcohol, spicy foods, and acidic foods. Symptoms can also be decreased by eating smaller quantities during meals and not lying down within two hours of eating. If symptoms only occur occasionally, say less than three times per week, occasional use of an over-the-counter antacid can resolve the symptoms. More persistent symptoms may be treated by a doctor using an over the counter H2 antagonist like Zantac. M: without physician supervision, these medicines really should only be taken for a short period, not exceeding two weeks. I will often use these medicines for a 30 day period followed by a recheck. Patients continuing to have symptoms after this treatment are referred to a gastroenterologist for endoscopy. The gastroenterologist will check for serious disorders which can even include cancer of the digestive tract. Most patients do not have a serious disorder and many end up doing best continuing on these medicines long-term. G: we hope this gives you a better understanding of the concerns surrounding the use of proton pump inhibitors and kidney disease. If you are taking these medications for longer than a couple weeks without the supervision of a physician we urge you to make an appointment to discuss it with your doctor. Please be sure to subscribe to my channel and use the card to visit Dr. Vaughan's Auburn Medical Grp channel where you can find over 100 videos on medical topics and demonstrating medical procedures. dr Vaughan, this was great. thanks for being a guest on my channel. M:. Thanks for having me.I loved it. I hope to do more of these in the future. G: and that's Headlines in Health
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Text Comments (20)
mark dixon (4 months ago)
Hello, I was diagnosed with a chronic esophagus disease about 10 years ago. My Gastro intestinal specialist put me on Omeprazole and doubled the dose daily. I have been doing this for almost 10 years now. Could I be in trouble? I have briefly gone off of Omeprazole only to suffer greatly with this esophagus disease and had to go back on Omeprazole which practically makes The disease undetectable to me in my daily life. Thank you
Mark Jones (7 months ago)
Look it up fish oil and co q10 cures ulcers both good for you look it up and start taking it coming from a guy that cured his ulcer by doing just that and change some foods you eat it's pretty simple and tums is good
Andrew B (1 year ago)
hi my doctor has me taking ppi's at 60 mg a day for just over 4 and a half years noticing pain in joints and back any advice?
hi (2 months ago)
Andrew B Lowe dose, first. Why are you on it?
TodaysRealHealth (1 year ago)
Stomach ulcers are cured with organic cayenne pepper in vegan capsules taken daily first with food, later without food.
Larry Kaminer (1 year ago)
Great video. I am surprised that the PPI are so readily available w no supervision. Does long term dual therapy, besides potential renal compromise, interfere with absorption of nutrient and binding sites?
Turmoi11ed (1 year ago)
I have been taking 40mg of Nexium a day for 10+ years.
eugen sunic (1 year ago)
Any known side effects from your part?
Mollie Smith (1 year ago)
They even put her through a procedure of running a tube through her liver to the bile duct to dislodge a stone, THAT THEY NEVER SAW ON ANY SCAN AND WASNT EVEN THERE!! When she died the pain she suffered was like her having Gout from HEAD TO TOE!!! Not on time did anyone ever tell the nurses to be very careful of moving her because of that. They just came in and rolled her over, while she SCREAMED!!!! Their response to her was to calm down!! Then they would ask HER why she was in so much pain???!!! I pray every day for forgiveness. I have lost ALL faith in physicians. They are bought and owned by pharmaceutical companies.
Mollie Smith (1 year ago)
Our family was subjected to so many arrogant remarks by her physicians, when we asked why they didn't know what was wrong or as to they could not give a diagnosis. The attending physician of the intensive care unit even discouraged us from having an autopsy!! I will never trust another Dr for as long as I live. On top of everything, MY MOTHER DID MOT HAVE TO DIE!!! Our lives will forever be saddened from the loss of her, but EVERY person who had any contact with her care gets to go on with life unaffected. On another side of this tragedy is the fact of the COUNTLESS AND UNNECESSARY test, scans and procedures the "Medical Experts" preformed and ordered. Not ONE TIME did any Dr say "Let's look at the medicine she takes to see if one of those may be the problem". They were never going to find a mass or lesion or disease, because the PPI meds were killing her, but they kept right on or ding test after test,scan after scan.
Mollie Smith (1 year ago)
With all the mumble jumble Doctors are spouting, all I can say is, IF YOU ARE TAKING A PPI MED OR SOMEONE YOU LOVE IS CURRENTLY TAKING THESE MEDS, STOP!!!! THE SPECIALISTS,i.e. Nephrologist, Endocrinologist,Gastroenterologist, WILL NOT SAVE YOUR LIFE!!! My mother passed away and not one of her specialists would give a diagnosis. They just said "We don't know what is wrong with her". Yet she had a creatinine level 2yrs ago that indicated kidney injury. She was seeing a Nephrologist,who in the hospital, acted like he didn't know what was wrong. Now either he was an uninformed idiot, or his loyalty was to the pharmaceutical companies. What NO ONE even addresses is the HORRIBLY PAINFUL death that she endured!!!!!!
Mark Jones (7 months ago)
Mollie Smith The only good things that come from doctors is babies
Mollie Smith (1 year ago)
+Helen Rowley - I have heard that there is a chance of reversal. It is an intensive therapy done by an endocrinologist. It consists of putting the vitamins and minerals back into the body. This is a crude description of the process and treatment. I had to search and search to find out about it. This can be done even while on dialysis and the treatment can reverse need for dialysis. How a person gets referred to the endocrinologist specifically for this treatment is the tricky and hard part. Remember that physicians who prescribe these PPI meds have signed away their Hippocratic oath in exchange for the perks/money/gifts that the big pharmaceutical are using to push this drug!!! You will have to demand that the referral and treatment be given and probably have to change doctors many times. The physicians will act like they don't of any such treatment but that is a flat out lie. This is why they are so vague on the diagnosis and how the damage was caused. I would have gone through hundreds of doctors if I had known.
Helen Rowley (1 year ago)
So sorry to hear about your experience, it is truly terrible. My father has had his health wrecked by the PPI meds he took continuously for 7 years. Just found out today they are offering to remove his kidney. Not had chance to talk to my dad yet about the PPI connection to the kidney problem and doubt the doctors have either. So saddened to hear your story. These drugs are being given out like sweeties to everyone, two of my friends have been prescribed them in the last week!
Saboth (2 years ago)
Scary. I've had problems with acid reflux for years, every single day, even before I was overweight. My gastroenterologist put me on prilosec 20mg 2x a day indefinitely. I dialed that down to one per day and it seemed to do the job, but any day I don't take it, the acid reflux/gerd comes back immediately. Been taking it for years, hopefully there is no permanent kidney damage. Not really something I can only take every so often, or the problems come back that same day.
Al Cameron (1 year ago)
Pickles and diet Pepsi help me.
JMac92430 (1 year ago)
Exercise and eat healthy. It will take a few weeks to see results, as Nexium and Prilosec
J H Peterson (2 years ago)
http://www.slideshare.net/PAWANVKULKARNI/review-of-new-alerts-on-proton-pump-inhibitors-ppi-adverse-effects-2015-55022824
J H Peterson (2 years ago)
We need to know, though they are observational studies, yet, why they came up offlate with what was unexpected? Not just KIDNEY disease, acute kidney injury & acute interstitial nephritis, PPIs are associated with Increased risk of Myocardial infarction associated with PPIs (even in general population) & ischemic cardiovascular events. PPIs with ASPIRIN – Higher mortality rates. Even causes Anaemia by B12 absorption. PPIs issues with Clopidogrel raised lot of alarm by even USFDA, Even Hyperparathyroidism is reported and Clostridium difficile associated GI infections & Hypomagnesaemia. All are compiled here in this slideshare link below
J H Peterson (2 years ago)
Also now JAMA published PPI and DEMENTIA

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