One of the possible complications of long-term proton pump inhibitor (PPI) use is renal damage.
Patient selection: chronic use of proton pump inhibitors (PPI)
Adverse renal effects:
(1) interstitial nephritis
(2) nephrolithiasis
(3) chronic kidney disease NOS
Risk factors:
(1) long-term use
(2) higher dose
(3) age >= 65 years
(4) concurrent kidney disease (hypertension, other)
Differential diagnosis:
(1) nephrotoxicity from concurrent NSAID use
Recommendations:
(1) stop proton pump inhibitor therapy if possible
(2) use the lowest possible dose
(3) monitor serum creatinine regularly
(4) avoid concurrent use with NSAIDs or other nephrotoxic drugs
