Systematic review: proton pump inhibitor‐associated acute interstitial nephritis

摘要: Summary Background  A number of recent case reports and series suggest that proton pump inhibitors may cause acute interstitial nephritis. Aim  To establish the nature relationship (cause or association) between inhibitor use development nephritis. Methods  Data collection: Two researchers independently searched electronic databases (MEDLINE, EMBASE, GOOGLE, LILACS, COCHRANE) for articles from 1970 to 2006, including all study designs, populations languages. independent reviewers assessed quality collected data. Selection criteria: absence baseline renal failure, nephritis after exposure, confirmed by creatinine plus either biopsy recurrence upon reinitiating inhibitor. Results  Sixty four cases (60% females, mean age 78 years) inhibitor-associated were found, 60 included in this review (59 biopsy, one inhibitor). The most common symptoms non-specific. treatment duration before diagnosing was 13 weeks, average recovery time 35.5 weeks, patient required permanent dialysis, there no deaths. Conclusion  Proton inhibitor-related is rare, idiosyncratic difficult predict. It requires a high level clinical suspicion. While not sufficient evidence causal with certainty, does appear be low-prevalence association.