Even when Chronic Kidney Disease (CKD) patients limit foods that are high in phosphorus, most still find themselves with high phosphorus levels. Antacids such as Tums, are used as effective binders to prevent phosphorus absorption by combining with the phosphorus in CKD patients' intestinal tract. However, a new study released on December 11th, 2013 in the Journal of the American Medical Association (JAMA) found that using Antacid medication consistently for 2 years or more is linked to a deficiency of vitamin B12, which can cause serious adverse effects for the nervous system including dementia neurologic damage, anemia and more. Due to the fact that most patients will require 3 to 6 antacids with every meal these findings may be cause for concern.
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Researchers note that antacids, including proton pump inhibitors (PPIs) and histamine 2 receptor antagonists, are some of the most commonly used pharmaceuticals. Since the medications suppress the creation of gastric acid, antacids may lead to poor absorption of vitamin B12 which helps to keep the nervous system (brain, nerves and spinal cord) healthy.
Researchers also mention that using antacids "identifies a population at higher risk of B12 deficiency." Davita Health Care Partners recommend a 2-3 ug/day B12 supplement for CKD patients who are deficient, but mention to "Always include B12 supplement with folate."
The study concluded that the findings "do not recommend against acid suppression for persons with clear indications for treatment, but clinicians should exercise appropriate vigilance when prescribing these medications and use the lowest possible effective dose." KidneyBuzz.com recommends that readers discuss this new finding with their Nephrologists before making any medication changes.
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"The ABCs of Vitamins for Kidney Patients." Http://www.davita.com/. DaVita HealthCare Partners Inc.
Ellis, Marie. "Long-term Antacid Use Linked to Vitamin B12 Deficiency." Medical News Today. MediLexicon International.