renal impairment and ppi/omeprazole
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renal impairment and ppi/omeprazole
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Hi, would appreciate any advice on this one. A 64 year old lady who had normal renal function a Chile of years ago had some bloods done. Her egfr was 59 in June this years, last week it was 53. She ha
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renal impairment and ppi/omeprazole
posted at 13/9/2012 4:19 AM BST
on bmj.com
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Posts: 2
First: 13/9/2012 Last: 13/9/2012 |
Hi, would appreciate any advice on this one. A 64 year old lady who had normal renal function a Chile of years ago had some bloods done. Her egfr was 59 in June this years, last week it was 53. She has no past medical history to speak of, doesn't smoke, drink, bmi is 19. Eats a healthy diet. Bp 120/84. She started a ppi about 8 months ago for gord. Doesn't take nsaids or anything except the ppi. Could this be the cause? Her own gp has told her she has ckd and that's it. I just wonder if it's a possibility that the ppi might be causing interstitial nephritis. Only other thing is she has recently travelled, over past few years, to the tropics, but has never been obviously unwell. Thanks for any opinions. |
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Re: renal impairment and ppi/omeprazole
posted at 13/9/2012 6:14 AM BST
on bmj.com
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Posts: 499
First: 12/7/2010 Last: 11/6/2013 |
PPI induced interstitial nephritis is acute in nature, though they may occur between 2 weeks to 9 months of PPI exposure. To differentiate whether it is CKD or acute interstitial nephritis do a renal ultrasound - bilateral small kidneys, reduced cortical thickness and hyperechogenicity will indicate CKD. For interstitial nephritis you can do a routine urine examination - hematuria or casts may be present. Eosionophilia and raised CRP may be present in blood in case of acute interstitial nephritis - confirm with renal biopsy. |
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Re: renal impairment and ppi/omeprazole
posted at 13/9/2012 1:59 PM BST
on bmj.com
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Posts: 3059
First: 27/3/2012 Last: 13/6/2013 |
Interstitial nephritis can occur with all PPIs. Health professionals should be aware of this potential serious adverse drug reaction. AIN is difficult to diagnose, as symptoms are nonspecific, including oliguria, malaise, anorexia, nausea and vomiting. Some symptoms of AIN might initially be confused with the illness the drug was originally prescribed for, leading to a delay in diagnosis. Accurate and timely diagnosis and withdrawal of the offending drug can prevent potentially life-threatening renal failure. |
