PMID- 17014549
OWN - NLM
STAT- MEDLINE
DCOM- 20070118
LR  - 20220408
IS  - 1320-5358 (Print)
IS  - 1320-5358 (Linking)
VI  - 11
IP  - 5
DP  - 2006 Oct
TI  - Proton pump inhibitors and acute interstitial nephritis: report and analysis of 
      15 cases.
PG  - 381-5
AB  - AIM: Although proton pump inhibitors (PPI) are usually safe and effective 
      therapeutic agents, serious adverse effects can occur. The aim of the present 
      study was to report and analyse the clinical features of 15 patients with acute 
      interstitial nephritis (AIN) and acute renal failure from PPI that were referred 
      to renal services in Auckland over a period of 3 years. METHODS: The clinical 
      presentation, therapeutic drugs, demographic details and renal outcome of the 
      patients were considered. The population at risk and total PPI exposure were able 
      to be defined. The diagnosis of AIN was made by renal biopsy in 12 cases. In all 
      patients, the time-course of drug exposure and improvement of renal function on 
      withdrawal suggested PPI were causal. RESULTS: The median patient age was 78 
      years. The mean baseline serum creatinine level was 83 micromol/L, peak level 392 
      micromol/L, and recovery level 139 micromol/L. The erythrocyte sedimentation rate 
      (ESR) and C-reactive protein were elevated at the time of diagnosis in the 11 and 
      12 patients, respectively, where this information was collected (ESR mean 85 
      mm/h, and C-reactive protein mean 81 mg/L). AIN occurred at 8 per 100 000 patient 
      years (95% confidence level 2.6-18.7 per 100 000 patient years). Although four 
      patients presented with an acute systemic allergic reaction, 11 were asymptomatic 
      with an insidious development of renal failure. CONCLUSION: PPI are now the most 
      commonly identified cause of AIN in the Auckland area. Recovery occurs after 
      withdrawal of the drug but is often incomplete. Early diagnosis may be 
      facilitated by clinician awareness of the insidious onset of renal failure, and 
      an elevated erythrocyte sedimentation rate and C-reactive protein.
FAU - Simpson, Ian J
AU  - Simpson IJ
AD  - Department of Medicine, Faculty of Medical and Health Sciences, University of 
      Auckland, New Zealand. i.simpson@auckland.ac.nz
FAU - Marshall, Mark R
AU  - Marshall MR
FAU - Pilmore, Helen
AU  - Pilmore H
FAU - Manley, Paul
AU  - Manley P
FAU - Williams, Laurie
AU  - Williams L
FAU - Thein, Hla
AU  - Thein H
FAU - Voss, David
AU  - Voss D
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Nephrology (Carlton)
JT  - Nephrology (Carlton, Vic.)
JID - 9615568
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Enzyme Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - D8TST4O562 (Pantoprazole)
RN  - KG60484QX9 (Omeprazole)
SB  - IM
CIN - Nephrology (Carlton). 2006 Oct;11(5):379-80. PMID: 17014548
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/adverse effects
MH  - Acute Kidney Injury/*chemically induced/epidemiology/pathology
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Ulcer Agents/adverse effects
MH  - Biopsy
MH  - Blood Sedimentation
MH  - C-Reactive Protein/metabolism
MH  - Enzyme Inhibitors/*adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nephritis, Interstitial/*chemically induced/epidemiology/pathology
MH  - Omeprazole/*adverse effects
MH  - Pantoprazole
MH  - *Proton Pump Inhibitors
MH  - Risk Factors
EDAT- 2006/10/04 09:00
MHDA- 2007/01/19 09:00
CRDT- 2006/10/04 09:00
PHST- 2006/10/04 09:00 [pubmed]
PHST- 2007/01/19 09:00 [medline]
PHST- 2006/10/04 09:00 [entrez]
AID - NEP651 [pii]
AID - 10.1111/j.1440-1797.2006.00651.x [doi]
PST - ppublish
SO  - Nephrology (Carlton). 2006 Oct;11(5):381-5. doi: 
      10.1111/j.1440-1797.2006.00651.x.