PPI's & the Association with Chronic Kidney Disease & Dementia

PPI's and Chronic Kidney Disease

Recently, a study was published in the Journal of the American Medical Association (JAMA) that discussed an association of chronic kidney disease with PPI use; it was titled, “Proton Pump Inhibitor use and the Risk of Chronic Kidney Disease (CKD).”

  • This study is an association study – which does not prove cause.
    The authors studied two populations (one with 10,482 patients and one with 24,8751 patients). In both, patients who did not use PPIs had a lower incidence of chronic kidney disease (13.6% vs 17.3% in the smaller study, 13.9% vs. 15.6% in the larger study. The differences were on the order of 1.7% to 3.7% more in the PPI groups). The media only reported what is called the increased “relative risk” of 20-50% - but this number tells nothing about the actual number of patients that were diagnosed.
  • Furthermore, in these studies, only an association was demonstrated – which is different than being proven to be the cause.
    As a result, the authors suggested a formal study where patients could be followed over a period of time.

PPI's and Dementia

Another study was published in JAMA Neurology that discussed an association of dementia with PPI use, titled, “Association of Proton Pump Inhibitors with Risk of Dementia.”

  • Again, this is an association study – which does not prove cause.
    The authors studied the claims data from a health insurer and compared patients over age 75 and evaluated for the difference in risk for dementia in those who didn’t take PPIs and those who did. Those patients who were on PPI medications (curiously nearly 80% of them female) had a higher risk (44%) of dementia than those who did not. Again, the media only reported on the risk and did not report on the actual number of patients who were affected. In fact, the study authors actually did not report the actual numbers of patients affected.
  • Again, only an association was found, not causation.
    The authors also suggested a formal study where patients could be followed over a period of time.

PPI's and Your Health

The FDA has not issued a statement or restriction, and these drugs are approved for over the counter use. As with all drugs, PPIs have potential side effects.

If you are currently on PPIs as a long term treatment plan, the medication should not be stopped without talking to your doctor about the risks and benefits of stopping the medication. Lifestyle changes may reduce or eliminate the need for PPIs for long term use for some conditions.

If you have further concerns about your treatment plan, please make an appointment with your gastroenterologist, who can discuss this further with you.