RENAL-DISEASE AND ACID-SUPPRESSING DRUGS

No comparative epidemiological data can be found in the literature on the renal safety of acid-suppressing drugs. We followed-up a cohort of close to 180,000 persons during periods of treatment and non-treatmen t with five anti-ulcer drugs to evaluate the risk of idiopathic acute renal failure and/or nephrotic syndrome. After reviewing medical recor ds, five patients were found to be cases. Two presented with acute ren al failure and three had nephrotic syndrome. Three cases occurred duri ng periods of non-exposure to anti-ulcer drugs. Two cases occurred dur ing current use of ranitidine: one of acute renal failure and one of n ephrotic syndrome. No case was encountered during treatment with cimet idine, famotidine, nizatidine or omeprazole. The incidence of idiopath ic renal disease in the general population was 1 per 100,000 person-ye ars. The relative risk associated with use of acid-suppressing drugs w as 1.8 (95% CI, 0.3-10.7) compared to non-use. These results do not su ggest a major increased risk for acute renal injury and/or nephrotic s yndrome associated with use of anti-ulcer drugs. (C) 1997 John Wiley & Sons, Ltd.