A Histopathological Study of Proton Pump Inhibitors: Are They Safe on Kidneys?

Background: In India, PPI is used between 45 and 85 percent of the cases. Patients with chronic renal disease were prescribed PPI in 82.96 percent of cases. However, recent case reports imply that PPI can cause AIN. Because many patients take numerous medications, it's impossible to assess the exact rate of this uncommon side event, making it much more difficult to establish a causal link between AIN and PPI. Early identification of AIN and discontinuation of the culprit drug may prevent AIN from progressing to end-stage chronic renal disease. As a result, we planned a study to determine whether or not there is a link between PPI and AIN.

Methods: The study was aimed at finding out histopathological impact of concomitant use of PPI and NSAID or AMA on experimental animal. The objectives were to find out the effect of concomitant administration of PPI with NSAIDS / antimicrobials on kidneys by histopathological studies and to compare it with normal histopathological picture to note the changes that have occurred due to drug administration. Rats weighing 150-250 gm were employed in the experiment. Omeprazole, pantoprazole, and rabeprazole were given for 28 days in three groups: group A was given nothing, group B was given diclofenac, and group C was given ofloxacin. After the 28th day, the animals with disordered RFTs were put together. Each group had two animals sacrificed. Their histopathology examinations were also completed.

Results: Each group had at least three rats with abnormal RFTs. And, with or without AIN, the majority of histopathological studies demonstrate structural and vascular alterations.

Conclusions: PPI alone are known to cause AIN, but the risk of AIN rises when other nephrotoxic drugs are added.