Heartburn drugs linked with kidney disease according to a new study. But, the study doesn’t establish a direct cause-and-effect relationship between the drugs and chronic kidney disease. Confused? Let’s dig deeper.

Prilosec, Nexium and Prevacid are very popular over-the-counter and prescription medications and belong to this class of drugs. They were used by more than 15 million Americans in 2013 and treat heartburn and acid reflux by lowering the amount of acid produced by the stomach.

A 20 percent to 50 percent higher risk of chronic kidney disease was shown in people who use these proton pump inhibitors (PPIs) compared with those who don’t, said lead author Dr. Morgan Grams, an assistant professor of epidemiology at Johns Hopkins University in Baltimore. The study was published Jan. 11 in JAMA Internal Medicine.

“We found there was an increasing risk associated with an increasing dose. That suggests that perhaps this observed effect is real,” according to Dr. Grams. He goes on to say, “Use of the prescription heartburn drugs already has been linked to short-term kidney problems such as acute kidney injury and an inflammatory kidney disease called acute interstitial nephritis”. Newer studies now show a link between the drugs and chronic kidney disease, in which the kidneys lose their ability to filter blood effectively.

In all those studied, researchers associated use of the drugs with an increased risk of chronic kidney disease over 10 years. The researchers also compared people using the drugs once a day with people who used them twice a day. They found twice-daily use was associated with a 46 percent increased risk of chronic kidney disease, versus a 15 percent increased risk in those taking one daily dose.

But the researchers cannot say definitively what causes the kidney damage. But, there are some plausible theories. One theory is the population of people in the study were older and tended to have more health problems such as obesity, high blood pressure and heart problems. Another theory is these medications can cause magnesium levels to decline in the body, and a lack of this important mineral could damage the kidneys.

Why would PPI’s lower magnesium levels? A simple understanding of how the body works explains it clearly.

The stomach secretes stomach acid for many reasons. One is to begin the process of digestion of proteins. Another is to provide an acidic environment that many bacteria cannot live in. This protects us from some of the many bacteria we may ingest in our food. But the concept least understood by most people is the acid begins the preparation of minerals like magnesium and calcium for easier absorption in the small intestine. Without proper amounts of stomach acid present, these and other minerals will be excreted and not absorbed. Hence, lowered levels of magnesium and the kidneys can suffer.

Heartburn and acid reflux can be successfully treated with dietary changes. Why risk your kidneys or how about your bone health? Remember, if magnesium is not prepared properly for absorption by stomach acid, neither is calcium. Or any other mineral.