Common Heartburn Medicines May Link to Kidney Trouble

If you’re one of the millions of Americans who takes one of a class of anti-reflux meds such as Nexium, Prilosec and Prevacid, take heed: These drugs have been linked to higher odds of kidney trouble.

The study couldn’t prove cause-and-effect — it’s possible that folks who need these heartburn medicines are simply more prone to kidney disease for other reasons. But the review of data did show a link.

The medicines in question are called proton pump inhibitors (PPIs). They reduce stomach acid production and are among the most widely prescribed medications in the world.

According to a team led by Dr. Charat Thongprayoon, of Bassett Medical Center in Cooperstown, N.Y., recent research has suggested an increased risk of kidney problems for people who take the drugs, but those findings were inconsistent.

Probing deeper, the researchers reviewed data from five studies that included a total of nearly 537,000 people.

They found that people who took a PPI were a third more likely to develop chronic kidney disease or kidney failure than those who didn’t take the drugs.

The findings were to be presented Saturday at the annual meeting of the American Society of Nephrology (ASN), in New Orleans.

“This study demonstrates a significant association between the use of PPIs and increased risks of chronic kidney disease and kidney failure,” Thongprayoon said in an ASN news release.

He stressed that cause-and-effect wasn’t confirmed. However, Thongprayoon believes that doctors “should consider whether PPI therapy is indicated for patients. Chronic use of PPIs should be avoided if not really indicated.”

Two kidney specialists said the new research does have value.

“It is important to always evaluate potential side effects — not only of medications but of treatments and procedures in general,” said Dr. Ernesto Molmenti. He directs adult and pediatric kidney transplantation at Northwell Health in Manhasset, N.Y.

Dr. Maria DeVita helps direct kidney care at Lenox Hill Hospital in New York City. She noted that PPIs — some of which have gained over-the-counter status in recent years — “are one of the most commonly ingested medications worldwide.”

Also, DeVita said, “PPIs were originally used for a limited time, but now, people may continue to use them for years.”

While it remains to be proven that the drugs cause kidney trouble, “we should reconsider our prolonged use of PPIs from time to time to make sure that the benefits outweigh potential risks,” she said.

Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Source: HealthDay


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Coffee May Be Kind to Your Kidneys

Steven Reinberg wrote . . . . . . .

Can caffeine help people with chronic kidney disease live longer?

That’s the suggestion of a new study that found that among more than 2,300 Americans with chronic kidney disease, those who drank the most caffeinated drinks reduced their risk of premature death by 24 percent.

“Our study showed a dose-dependent protective effect of caffeine consumption on all-cause mortality among patients with chronic kidney disease,” said lead researcher Dr. Miguel Bigotte Vieira, from the Centro Hospitalar Lisboa Norte, in Lisbon, Portugal.

“However, our observational study cannot prove that caffeine reduces the risk of death, but only suggests the possibility of such a protective effect,” he said.

Moreover, the reasons that caffeine might be protective aren’t clear, and how much caffeine is too little and how much might be too much also isn’t known, Bigotte Vieira added.

The findings also need to be replicated in a trial that compares caffeine consumption with no caffeine consumption before patients are counseled to drink more coffee or other caffeinated drinks, he noted.

In the study, the research team found that:

  • those who consumed the least amount of caffeine saw no reduction in death risk,
  • those who had the second higher amount reduced their risk by 12 percent,
  • those who had the third higher amount reduced their risk by 22 percent,
  • and those who consumed the most caffeine reduced their risk by 24 percent.

The association between caffeine and a reduced risk of premature death was independent of factors such as age, gender, race, family income, education, creatinine levels (a marker of kidney troubles), high blood pressure, smoking, high cholesterol, body weight, previous cardiovascular problems and diet, Bigotte Vieira said.

The findings were to be presented Friday at the American Society of Nephrology annual meeting, in New Orleans. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

Dr. Leslie Spry, from the Lincoln Nephrology & Hypertension, Dialysis Center in Nebraska, said, “I hope this is the case, as I sit here and drink my morning coffee.” Spry is also a spokesman for the National Kidney Foundation.

“As you know, there are studies of coffee being harmful, beneficial and having no effect on health,” he said.

This is yet another observational study, Spry noted, where only an association was found, not cause and effect.

Given the relatively small size of the study, and the small reduction in death risk, Spry said he’s not willing to tell kidney patients that the more caffeine they drink, the longer they’ll live.

“I would rather say that compared to little or no caffeine intake, those people with the highest intake of caffeine as estimated by dietary recall, may have a lower mortality, but the reason for this lower mortality is not proven by this association research,” he said.

Source: HealthDay


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Kidney Disease May Boost Odds of Infection

As kidney function declines, infection risk rises, a new study shows.

Infections facing people with advanced kidney disease include lower respiratory tract disease, urinary tract infections and blood poisoning, researchers said.

The findings were published in the Clinical Journal of the American Society of Nephrology.

“Given the fact that chronic kidney disease remains underdiagnosed and unrecognized in most societies, our findings may help patients and clinicians become more aware of chronic kidney disease and its complications,” said co-lead author Juan Jesus Carrero, of the Karolinska Institute in Sweden.

“This in turn may be useful to identify patients at increased risk of infection and inform discussions about prevention strategies, such as vaccination and health service planning,” Carrero said in a journal news release.

The researchers tracked 12 months of data from 1.1 million Swedes who took part in a study examining measures of kidney function.

The researchers found that infection rates grew almost sixfold in people with stage 4 or higher chronic kidney disease, compared to people with normal kidney function. Several types of infection — lower respiratory tract infections, urinary tract infections and sepsis — made up a larger proportion of infections as kidney function worsened.

The study focused on infections that people develop in the community, not hospitals and other health care settings.

Source: HealthDay


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Kidney Disease May Boost Risk of Abnormal Heartbeat

Dennis Thompson wrote . . . . . . .

People with failing kidneys are at increased risk of developing a life-threatening abnormal heart rhythm, a new report suggests.

Chronic kidney disease can as much as double a patient’s risk of atrial fibrillation, a quivering or irregular heartbeat that can lead to stroke or heart failure, said lead researcher Dr. Nisha Bansal. She is an associate professor of nephrology at the University of Washington’s Kidney Research Institute, in Seattle.

The risk of atrial fibrillation increases as kidney function declines, Bansal said.

“We saw the worse your kidney function, the greater your risk of developing atrial fibrillation. Even mild changes in kidney function were strongly linked to atrial fibrillation,” Bansal noted.

The study included data gathered from three separate research projects focused on heart health in the United States. The three projects created a combined pool of almost 17,000 patients with follow-up periods averaging between 8.5 years and 12.5 years. None of the participants had atrial fibrillation when first recruited.

Each project checked participants’ kidney function when they first joined the study, using one or two different lab tests. One was a blood test that evaluated how well the kidneys were removing toxins from the bloodstream. The other was a urine test that assessed whether the kidneys were properly filtering out a specific protein.

People with worse kidney function at the start of the study were more likely to have atrial fibrillation by the end, the researchers found. Those who did worse on the blood test were twice as likely to develop an abnormal heart rhythm, while those who did worse on the urine test were 76 percent more likely.

While the association doesn’t prove a cause-and-effect relationship, the link remained even after the researchers took into account other risk factors for atrial fibrillation, such as diabetes, tobacco use and a history of heart problems.

“We found that kidney function was independent of all other risk factors,” Bansal said.

Research has not yet been conducted to explain the association between kidney function and atrial fibrillation, Bansal noted, but there are a number of possible explanations.

A poorly functioning kidney can alter blood levels of a number of nutrients needed to maintain proper heart function, such as potassium, vitamin D, calcium and phosphorus, Bansal said.

The kidneys also are responsible for maintaining a steady volume of blood in your body, removing excess fluid by way of urination.

“If your kidney function is impaired, your blood volume increases,” Bansal said. “That increased stress on your heart causes it to stretch and can also trigger this abnormal heart rhythm.”

Dr. Kevin Chan, a nephrologist with Massachusetts General Hospital in Boston, noted that it’s also possible toxins that haven’t been filtered from the blood — thanks to a bad kidney — might have some as-yet-unknown effect on heart function.

Based on this report, doctors treating patients with kidney disease should keep an eye out for potential heart problems, said Chan, who was not involved with the new study.

“Physicians should be cognizant of this relationship so they are attuned to recognizing atrial fibrillation when they see their chronic kidney disease patients,” Chan said.

Doctors can reduce a person’s risk of stroke from atrial fibrillation by putting them on blood thinners, he added. Atrial fibrillation patients also can be fitted with a pacemaker, or undergo a procedure to restore proper heart rhythm.

People with kidney disease could help themselves by adopting a heart-healthy lifestyle, Bansal suggested, for example, eating right, exercising and quitting smoking.

“A heart-healthy lifestyle does improve your risk of all kinds of cardiovascular disease, as well as kidney disease, so I would recommend that,” Bansal advised.

The report was published online in the Clinical Journal of the American Society of Nephrology.

Source: HealthDay

Kidney Disease: Causes

Your kidneys may be small, but they perform many vital functions that help maintain your overall health, including filtering waste and excess fluids from your blood. Serious kidney disease may lead to complete kidney failure and the need for dialysis treatments or a kidney transplant to stay alive. While effective treatments are available for many kidney diseases, people are sometimes unaware that kidney disease can often be prevented. The following are the ten major causes of kidney disease.

In the United States the two leading causes of kidney failure, also called end stage kidney disease or ESRD, are diabetes (also called Type 2, or adult onset diabetes) and high blood pressure. When these two diseases are controlled by treatment, the associated kidney disease can often be prevented or slowed down.

Many effective drugs are available to treat high blood pressure. In addition, healthy lifestyle changes, such as losing weight and regular exercise, often help to control, and may even help to prevent, high blood pressure.

Careful control of blood sugar in diabetics helps to prevent such complications as kidney disease, coronary heart disease and stroke. When diabetics have associated high blood pressure, special drugs called angiotensin converting enzyme (ACE) inhibitors may help to protect their kidney function.

The third leading cause of end stage kidney disease in the U.S. is glomerulonephritis, a disease that damages the kidneys’ filtering units, called the glomeruli. In many cases, the cause of this disease is not known, but some cases may be inherited and others may be triggered by an infection.

Some of the other diseases that may affect the kidneys include infections, kidney stones and inherited diseases such as polycystic kidney disease. The kidneys can also be damaged by overuse of some over-the-counter pain killers and by taking illegal drugs such as heroin. Some of these diseases can be cured. In other cases, treatments can help to slow the disease and prolong life.

End stage kidney disease occurs when about 90 percent of kidney function has been lost. People with kidney failure may experience nausea, vomiting, weakness, fatigue, confusion, difficulty concentrating and loss of appetite. It can be diagnosed by blood and urine tests.

Source: National Kidney Foundation