质子泵抑制剂与急性肾损伤

Proton pump inhibitors and acute kidney injury

质子泵抑制剂(proton pump inhibitors,PPIs)作为一种抑酸药物广泛应用于各种酸相关性疾病中,是目前医院最常用药物之一,部分患者需要长期服药,其安全性及其重要。其对各系统的不良反应已经多有报道,近年来,PPIs导致的药物性肾损伤也逐渐引起临床关注,PPIs引起的急性肾损伤,病理表现为PPIs相关性急性间质性肾炎,而长时间应用PPIs则可由慢性间质性肾炎进展为慢性肾脏病甚至肾功能衰竭。PPIs引起急性间质性肾炎(acute interstitalrephritis,AIN)的发病率及其机理尚不清楚。临床对PPIs相关急性肾损伤认识不足,可能导致漏诊及延误治疗。本文就目前资料进行综述,总结了PPIs引起肾损伤的可能机制、临床表现及治疗,以期引起临床医生对PPIs肾损伤的关注。

Proton pump inhibitors(PPIs),as an acid suppressant,are widely used in various acid-related diseases.It is one of the most commonly used drugs in hospitals at present,and some patients require long-term medication,so the drug safety was very important.The drug adverse reactions to various systems have been reported for many times.In recent years,the drug-induced renal injury caused by PPIs has gradually attracted clinical attention.PPIs can mainly cause acute kidney injury,and the pathological manifestations are PPIs-related acute interstitial nephritis,while long-term application of PPIs can makes chronic kidney disease or even renal failure evolved from chronic interstitial nephritis.Currently,the incidence of acute interstital nephritis(AIN) AIN caused by PPIs and the mechanism of AIN remain unclear.Clinicians’ insufficient knowledge of PPIsrelated acute kidney injury may lead to missed diagnosis or delay the treatment.This article reviewed the current data and summarized the possible mechanisms,clinical manifestations and treatment of renal injury caused by PPIs,in order to arouse the clinician’s attention to renal injury induced by PPIs.