Tag Archives: Kidney Health

Proton Pump Inhibitors and Kidney Disease

Posted on by

Proton Pump Inhibitors and Kidney Disease

The prevalence of chronic kidney disease is increasing, with more than 20 million Americans affected by the disease. While it is well known that diabetes and hypertension are common risk factors, certain medications can also play a role and may be contributing to the epidemic.

According to two new studies that were just presented this past week at ASN (American Society of Nephrology) Kidney Week 2015 in San Diego, CA (November 3-8), certain acid reflux medications may have harmful effects on the kidneys. These types of medications, also known as proton pump inhibitors or PPIs, are among the top 10 prescribed medications in the United States.

In the first study, researchers from Johns Hopkins University followed 10,482 adults with normal kidney function from 1996 to 2011. They found that patients taking proton pump inhibitors were 20% to 50% more likely to develop kidney disease than patients not on these medications. These finding were not seen in patients using H2-blockers to suppress stomach acid.

In the second study, researchers from SUNY in Buffalo, NY found that among 24,149 patients who developed chronic kidney disease between 2001 and 2008, 25.7% were treated with PPIs. According to the study, those who took PPIs were less likely to have vascular disease, cancer, diabetes, hypertension, and COPD, but PPI use was linked to a 10% increased risk of chronic kidney disease and a 76% increased risk of dying prematurely.

If we know the potential adverse effects of PPI medications, we can look at better alternatives to avoid the risk of chronic kidney disease and reduce their overuse.

Pharmaceutical interventions may provide symptom management but they do not correct many of the underlying factors, and many have side effects. Lifestyle changes and nutritional support are usually sufficient to address acid reflux. Patients should be encouraged to eat smaller portions at mealtime. They should also avoid laying down after meals and eating too close to bedtime. Alcohol and specific foods can trigger symptoms, so it is beneficial to identify and eliminate these problematic areas.

Although these medications may help with the symptoms, proton pump inhibitors may not be the solution. We typically do not produce more hormones, insulin, and enzymes as we age. The truth is that most of our bodies’ processes decrease as we age. Most people suffering with acid reflux or GERD commonly are suffering from hypochlorhydria, which is when the stomach is unable to produce enough hydrochloric acid. Hypochlorhydria can lead to other problems such as small intestinal bacterial overgrowth (SIBO).

Nutritional supplementation may be beneficial to help improve digestive function, such as probiotics and glutamine. Deglycyrrhizinated licorice (DGL) is well established as an anti-ulcer and mucosal healing botanical, and is soothing and protecting to the gastric mucosa and mucous membranes lining the digestive tract.

Helicobacter pylori is a major cause of gastritis. Mastic gum, methylmethionesulfonium, zinc-carnosine and vitamin C address both eradication of H. pylori and the healing and protection of inflamed mucosal tissue.

These alternative approaches are typically more effective than what is provided by proton pump inhibitors and do not have side effects or other complications that may accompany PPI use, such as mineral deficiencies, bacterial infections, and dysbiosis.

Sources

Proton Pump Inhibitor Use Is Associated with Incident Chronic Kidney Disease Benjamin Lazarus, Yuan Chen, Francis Perry Wilson, Josef Coresh, Morgan Grams. Johns Hopkins Univ, Baltimore, MD; Royal Brisbane and Women’s Hospital, Queensland, Australia; Yale Univ School of Medicine, New Haven, CT.

Proton Pump Inhibitors Are Associated with Increased Risk of Development of Chronic Kidney Disease Pradeep Arora, Mojgan Golzy, Anu Gupta, Rajiv Ranjan, Randy L. Carter, James W. Lohr. Nephrology, VA Medical Center, Buffalo, NY; Medicine, SUNY, Buffalo, NY; Dept of Biostatistics, UB, Buffalo, NY.

 

Celery Seed Extract for the Blood and the Brain

Posted on by

Celery Seed Extract for the Blood and the Brain

Raw celery lends a crunch to crudité platters, and filling the stalks with peanut butter or cream cheese and raisins—“ants on a log”—is a surefire way to get kids to eat a vegetable they’d normally turn their nose up at. Combined with onions and carrots to create the classic culinary mirepoix, celery makes frequent appearance as the basis for savory dishes, especially in soups and stews. But celery’s usefulness isn’t limited to what it can do in the kitchen or in school lunchboxes. The tiny black seeds that grow into wild celery have impressive properties of their own.

Celery seeds contain 15% fatty oil, with the largest component being petroselinic acid (64.3%), a monounsaturated fat also found in coriander and parsley seed. The remainder contains linoleic (18%), oleic (8.1%), linolenic (0.6%), and palmitic acids. Celery seed is also composed of 2% volatile oil, which is employed as an ingredient in perfumes and food flavorings.

Celery seeds have been used in Traditional Chinese Medicine for a number of health concerns, particularly ones relating to cardiovascular function. Modern research techniques are now validating these beneficial effects. Studies in hypertensive rats support a role for celery seed extract in lowering blood pressure. One of the chemical constituents of celery seed oil, n-Butylphthalide (NBP), is a primary contributor to the flavor and aroma of celery, and it is this compound that is believed to be responsible for the antihypertensive effects. The reduced blood pressure may be due to diuretic and vasodilatory properties of celery seed. It is important to note that the reduced blood pressure was accompanied by a significant increase in the rats’ heart rate, which the researchers speculated was likely a way to compensate for the reduced blood pressure. The beneficial effects of any compound that may affect physiological function should always be weighed against other potential outcomes.

The same compound, NBP, has been shown to reduce kidney damage resulting from hypertension in rats, decreasing urinary albumin excretion and blood urea nitrogen levels. NBP at 15 or 30mg/kg daily for 20 weeks significantly decreased blood pressure and the rate of glomerulosclerosis. It also protected against impairment of renal tubule function, decreased oxidative stress, and reduced expression of pro-inflammatory cytokines in kidney tissue.

Celery seed extract (CSE) may also have beneficial effects for cardiovascular health. Cultured mouse macrophages pre-incubated with CSE experienced significantly less damage upon exposure to oxidized LDL particles. CSE decreased the secretion of inflammatory markers TNF-α and IL-6 by 12-27% and 5-15%, respectively. CSE was also shown to inhibit the apoptosis of macrophages that otherwise might have been induced by the oxidized lipoproteins. Pre-incubation of cells with CSE at 100 and 200 g/ml promoted cell viability by 28% and 40%, respectively. The apoptosis of macrophage foam cells in areas where phagocytic clearance is impaired is a contributing factor in the enlargement of atherosclerotic plaque.

Other conditions for which CSE has shown promise include stroke, vascular dementia, and Alzheimer’s disease. Rats given 20mg/kg of NBP isolated from celery seed exhibited protection from ischemia-induced injury to the hippocampus. They had reduced deficits in spatial learning, and performed better in a maze task. NBP may also protect against some of the neuronal damage induced by the amyloid-beta (Aβ) peptides associated with Alzheimer’s. Daily treatments of 10 and 30 mg/kg of this celery seed compound attenuated working memory deficits and inhibited neuronal apoptosis in rats that had received intracerebroventricular infusion of Aβ. Hyperphosphorylated tau proteins are another hallmark of Alzheimer’s disease. NBP was shown to reduce activation of glycogen synthase kinase-3β, the enzyme responsible for tau protein phosphorylation.

Finally, celery seed extract may have a role as a natural anti-inflammatory and analgesic. It has shown efficacy in reducing platelet aggregation and inhibits inflammatory prostaglandin-producing enzymes, COX-I and COX-II.

To date, much of the research on celery seed extract and NBP have employed relatively high doses of these compounds. Studies in rats indicate that even at doses of 5000mg/kg per day, there were no adverse effects.