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Proton pump inhibitors: are they safe on kidneys: a histopathological study

Ramachandra Prabhakar Limaye, Shabbir Rafik Pendhari, Kedar Shashikant Joshi.

Abstract
Background: In India the utilization of PPI varies to 45-85%. PPI were used in 82.96% patient with chronic kidney disease. But now a day’s several case reports are suggesting PPI induces AIN. The exact rate of this rare adverse event is difficult to estimate because many patients are taking multiple medications, which also make it difficult to establish a causal relation between AIN and PPI. Early detection of AIN and immediate discontinuation of culprit drug may prevent progress of AIN to the end stage chronic kidney disease. So we planned a study to establish the relationship between PPI and AIN, if any.
Methods: Rats weighing 150-250 gm were used. In this study omeprazole, pantoprazole and rabeprazole were administered for 28 day group A - alone, Group B-with diclofenac and group C - ofloxacin, after 28th day the animal with deranged RFTs were grouped 2 animals were sacrificed from each group. And there histopathological studies were carried out.
Results: At least 3 rats showed deranged RFTs in each group. And most of the histopathological studies show structural, vascular changes with or without AIN.
Conclusions: PPI alone are prone to cause AIN but the incidence of AIN is increases with addition of other nephrotoxic dugs.

Key words: AIN, Diclofenac, Histopathological examination, Ofloxacin, PPI



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