Contribuciones a Las Ciencias Sociales · Oct 27, 2026
Long-term use of IBPs and risk of dementia and chronic kidney disease
By Rezende GF, Sant’ana SR, Oliveira EMD et al.
Proton pump inhibitors (IBPs) are widely prescribed for the management of acid-peptic disorders, but their long-term use raises concerns about systemic risks, especially cognitive decline and chronic kidney disease (DRC). This integrative review evaluated the association between chronic use of IBPs and the development of dementia and kidney diseases, analyzing pathophysiological mechanisms and therapeutic alternatives. A systematic search of the PubMed/MEDLINE database was conducted in June 2026, selecting randomized clinical trials and prospective cohorts published between 2021 and 2026 (three articles included). For the neurocognitive outcome, the ASPREE cohort (n = 18.934 older adults, follow-up of 4.5 years) refuted a causal association between IBPs and the incidence of dementia (adjusted HR = 0.88; 95% IC: 0.72–1.08) or cognitive decline without dementia (adjusted HR = 1.00; 95% IC: 0.92–1.09), indicating that previous findings resulted from confounding factors. For renal outcomes, the subanalysis of the COMPASS study (n = 17.598, follow-up of 3.3 years) demonstrated an additional annual decline in estimated glomerular filtration rate (TFGe) of 0.27 mL/min/1.73 m² with pantoprazole (95% IC: 0.11–0.43) compared with placebo. In diabetic patients with kidney disease (n = 140), vonoprazan produced a greater reduction in albuminuria (β = 19.219; 95% IC: 13.62–24.817) and an improvement in TFGe compared with lansoprazole (p < 0.05). It is concluded that IBPs do not increase the risk of dementia, but subclinical renal functional decline necessitates periodic monitoring and conscientious deprescribing, with vonoprazan emerging as a promising nephroprotective alternative.