From the Guidelines
Omeprazole is generally considered safe for patients with one kidney, as it is primarily metabolized by the liver, not the kidneys, and thus doesn't typically put additional strain on kidney function. When prescribing medications like omeprazole to people with chronic kidney disease (CKD), it's essential to consider the benefits versus potential harms, as stated in the KDIGO 2024 clinical practice guideline 1. According to Practice Point 4.1.1, people with CKD may be more susceptible to the nephrotoxic effects of medications, emphasizing the need for careful consideration 1.
Key points to consider when taking omeprazole with one kidney include:
- Monitoring eGFR, electrolytes, and therapeutic medication levels, as indicated, to ensure safe use 1.
- Being aware of the rare but potential risk of acute interstitial nephritis, a type of kidney inflammation associated with proton pump inhibitors like omeprazole.
- Informing your healthcare provider about your single kidney condition when discussing any medication, including omeprazole, to determine the best course of action and potential need for periodic kidney function monitoring.
- Reporting any symptoms like changes in urination patterns, swelling, or unusual fatigue while taking omeprazole to your healthcare provider promptly.
It's crucial to follow the guidance outlined in Practice Point 4.1.2, which recommends monitoring patients with CKD receiving medications with potential adverse effects or nephrotoxicity 1. By taking these precautions and under the guidance of a healthcare provider, patients with one kidney can safely use omeprazole while minimizing potential risks to their kidney function.
From the FDA Drug Label
Omeprazole delayed-release capsules can cause serious side effects, including: • A type of kidney problem (tubulointerstitial nephritis). Some people who take proton pump inhibitor (PPI) medicines, including omeprazole delayed-release capsules, may develop a kidney problem called tubulointerstitial nephritis that can happen at any time during treatment with omeprazole delayed-release capsules
5.2 Acute Tubulointerstitial Nephritis Acute tubulointerstitial nephritis (TIN) has been observed in patients taking PPIs and may occur at any point during PPI therapy.
Omeprazole can be hard on the kidneys, as it may cause a type of kidney problem called tubulointerstitial nephritis. Patients with one kidney should be cautious when taking omeprazole and monitor their kidney function closely. If signs of kidney problems occur, such as a decrease in urination or blood in the urine, patients should call their doctor right away 2, 3.
From the Research
Kidney Impairment and Omeprazole Use
- Omeprazole use has been associated with an increased risk of kidney impairment, particularly in patients with pre-existing kidney disease 4, 5, 6.
- A study published in 2018 found that prophylaxis for digestive disorders with omeprazole was a risk factor for increased serum creatinine levels, indicating kidney impairment 4.
- Another study published in 2020 found that continuous use of omeprazole was associated with a higher risk of progression to worse stages of chronic kidney disease (CKD) 5.
- A 2021 study found that long-term continuous use of proton-pump inhibitors, including omeprazole, was associated with renal function decline in patients without acute kidney injury 6.
Omeprazole Use in Patients with One Kidney
- There is limited research specifically addressing the use of omeprazole in patients with one kidney.
- However, the available evidence suggests that omeprazole use may be associated with an increased risk of kidney impairment, which could be a concern for patients with a single kidney 4, 5, 6.
- A 2021 study found that omeprazole use was not associated with a significant effect on kidney transplant function, but this study was conducted in patients with stable kidney transplant function 7.
Potential Risks and Considerations
- Patients with one kidney taking omeprazole should be monitored closely for signs of kidney impairment, such as increased serum creatinine levels or decreased glomerular filtration rate 4, 5, 6.
- The use of omeprazole in patients with one kidney should be carefully considered, weighing the potential benefits against the potential risks of kidney impairment 4, 5, 6.
- Alternative treatments, such as histamine-2 receptor antagonists, may be considered for patients with one kidney who require acid suppression therapy 7, 8.