www.ijbcp.com International Journal of Basic & Clinical Pharmacology | July-August 2016 | Vol 5 | Issue 4 Page 1187 IJBCP International Journal of Basic & Clinical Pharmacology Print ISSN: 2319-2003 | Online ISSN: 2279-0780 Research Article Proton pump inhibitors: are they safe on kidneys: a histopathological study Ramachandra Prabhakar Limaye*, Shabbir Rafik Pendhari, Kedar Shashikant Joshi INTRODUCTION Proton pump inhibitors (PPI) are the most commonly used drug worldwide. Since 2006 such trends are observed in Australia, US, New Zealand. 1-3 Similarly several drug utilization studies were carried out in India, which showed that the use of proton pump inhibitors varies from 45-85% in different conditions. 4,5 PPI were also used in 82.96% patients suffering from chronic renal disease. 6 As this class of the drug is thought to be well tolerated, they are widely in use. However there have been case reports and case series which are reporting PPIs producing acute interstitial nephritis (AIN) progressing to acute renal failure (ARF). The first report of omeprazole induced AIN is reported in 1992 while that of pantoprazole and lansoprazole was reported on 2004, since then similar reports about all PPIs is coming. 1 Geevasinga et al reported 18 of 28 biopsy proven PPI induced AIN. 1 In southeast England during 2007 and 2008, Ray et al examined 210 kidney biopsies and found six cases of AIN which were strongly associated with PPI. 7 All these 6 patients are from geriatric age group. In the United Kingdom, eight reports were reported in four year periods. Analysis of Medicine and Healthcare Products Regulatory Agency reporting scheme in UK reports 74 cases of showing relation between AIN and PPI in 1992-2009 that is in nearly 17 years. 7 Harmark L et al has published seven patients’ case reports, three each ABSTRACT Background: In India the utilization of PPI varies to 45-85%. PPI were used in 82.96% patient with chronic kidney disease. But now a day’s several case reports are suggesting PPI induces AIN. The exact rate of this rare adverse event is difficult to estimate because many patients are taking multiple medications, which also make it difficult to establish a causal relation between AIN and PPI. Early detection of AIN and immediate discontinuation of culprit drug may prevent progress of AIN to the end stage chronic kidney disease. So we planned a study to establish the relationship between PPI and AIN, if any. Methods: Rats weighing 150-250 gm were used. In this study omeprazole, pantoprazole and rabeprazole were administered for 28 day group A - alone, Group B-with diclofenac and group C - ofloxacin, after 28 th day the animal with deranged RFTs were grouped 2 animals were sacrificed from each group. And there histopathological studies were carried out. Results: At least 3 rats showed deranged RFTs in each group. And most of the histopathological studies show structural, vascular changes with or without AIN. Conclusions: PPI alone are prone to cause AIN but the incidence of AIN is increases with addition of other nephrotoxic dugs. Keywords: AIN, Diclofenac, Histopathological examination, Ofloxacin, PPI DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20162220 Department of Pharmacology, Bharati Vidyapeeth Deemed University, Medical College and Hospital, Sangli, Maharashtra, India Received: 04 July 2016 Revised: 08 July 2016 Accepted: 12 July 2016 *Correspondence to: Dr. Ramachandra Prabhakar Limaye, Email: rplimaye@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open- access article distributed under the terms of the Creative Commons Attribution Non- Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.