Incidence, Pathogenesis, and Management of Proton Pump Inhibitor-Induced Nephrotoxicity

Xiao Wei, Jun Yu, Zhengkun Xu, Chun Wang () and Yonggui Wu ()
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Xiao Wei: The First Affiliated Hospital of Anhui Medical University
Jun Yu: Anhui Medical University
Zhengkun Xu: Anhui Medical University
Chun Wang: Anhui Medical University
Yonggui Wu: The First Affiliated Hospital of Anhui Medical University

Drug Safety, 2022, vol. 45, issue 7, No 2, 703-712

Abstract: Abstract Proton pump inhibitors are widely used in the treatment of various acid-related diseases and are among the most commonly used drugs. Studies estimate that 25–70% of proton pump inhibitors are prescribed for inappropriate treatments, doses, and indications, where the benefits of proton pump inhibitor use may be less than the risk of adverse drug reactions for many patients. Acute interstitial nephritis is an immune-mediated atypical kidney injury in the long-term use of proton pump inhibitors that causes problems for clinicians and patients. In this review, we summarize the current knowledge of proton pump inhibitors inducing acute interstitial nephritis, chronic kidney disease, and even end-stage renal disease in terms of incidence, pathogenesis, factors, clinical features, and diagnosis. We discuss how these factors change under conditions of acute interstitial nephritis, chronic kidney disease, and end-stage renal disease. The purpose of this review is to assess the current evidence to help clinicians and patients interpret the potential causal relationship between proton pump inhibitor intake and nephrotoxicity. This prompts clinicians to consider the appropriate dose and duration of proton pump inhibitor therapy to avoid inappropriate use.

Date: 2022
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DOI: 10.1007/s40264-022-01181-4

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