What syndromes involving the kidneys are associated with PPIs?
PPIs, regardless of class, can cause AIN.
Hyponatremia, likely the result of SIADH, is less common. Most PPIs are metabolized predominantly by hepatic CYP450 enzymes, in particular CYP3A4 and CYP2C19. PPIs can cause CNI toxicity due to their effects to reduce CNI metabolism by these 2 CYP450 enzymes. Hypomagnesemia is another complication of PPIs. This is due to reduced GI absorption rather than magnesium loss via the kidneys.
A reduction in TRPM-6/7 function, which are magnesium pores in apical membranes of gastrointestinal (GI) epithelial cells, lead to this effect. Discontinuation of the PPI generally reverses GI magnesium wasting.
