PPIs and kidney diseaseThe prevalence of chronic kidney disease (CKD) is increasing with more than 20 million Americans affected by the disease. Diabetes and hypertension are common risk factors, however, certain medications can also play a role and may be contributing to the epidemic.

According to two new studies that will be presented at ASN Kidney Week 2015 this week, acid reflux medications may have harmful effects on the kidneys. These medications are among the top 10 prescribed medications in the United States.

In one study, researchers from Johns Hopkins University followed 10,482 adults with normal kidney function from 1996 to 2011. They found that patients taking proton pump inhibitors (PPIs) were 20% to 50% more likely to develop kidney disease than patients not on this medication. These finding were not seen in patients using H2-blockers to suppress stomach acid. If we know the potential adverse effects of PPI medications we can look at better alternatives to avoid the risk of chronic kidney disease and reduce their overuse.

In another study, researchers from SUNY in Buffalo found that among 24,149 patients who developed chronic kidney disease between 2001 and 2008, 25.7% were treated with PPIs. According to the study, those who took PPIs were less likely to have vascular disease, cancer, diabetes, hypertension, and COPD, but PPI use was linked with a 10% increased risk of CKD and a 76% increased risk of dying prematurely.

Pharmaceutical interventions may provide symptom management but they do not correct many of the underlying factors and have side effects. Lifestyle changes and nutritional support are usually sufficient to address acid reflux. Patients should consider eat smaller portions at meals. In addition, avoid laying down after meals and avoid eating before bed. Also, alcohol and specific foods can trigger symptoms.

Although these medications may help with the symptoms, proton pump inhibitors may not be the solution. We typically do not produce more hormones, insulin, and enzymes as we age. The truth is that most of our bodies’ processes decrease as we age. Most people suffering with acid reflux or GERD commonly are suffering from too little acid called hypochlorhydria, which is when the stomach is unable to produce enough hydrochloric acid, which can lead to other problems such as small intestinal bacterial overgrowth (SIBO).

Nutritional supplements may be needed to improve your digestive function such as probiotics and glutamine. Deglycyrrhiizinated licorice (DGL) is well established as an anti-ulcer and mucosal healing botanical and is soothing and protecting to the gastric mucosa and mucous membranes lining the digestive tract.

Helicoacter pylori is a major cause of gastritis. Mastic gum, methylmethionesulfonium, zinc-carnosine and vitamin C address both eradication of H. pylori and the healing and protection of inflamed mucosal tissue.

An alternative approach is typically more effective than what is provided by proton pump inhibitors and does not have side effects or other complications that can be associated with them, such mineral deficiencies, bacterial infections, and dysbiosis .

By Michael Jurgelewicz, DC, DACBN, DCBCN

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