Popular heartburn medications taken by millions could lead to long-term kidney damage without any warning, a new study suggests, according to CBC News.

The drugs, called proton pump inhibitors, reduce the symptoms of heartburn by lowering the amount of acid in the stomach. They include the brand names Losec, Nexium, and Prevacid.

Doctors previously monitored patients for acute kidney problems, such as decreased urination, swelling in the legs, ankles, or feet, and nausea. Such symptoms were thought to be a warning of more permanent kidney damage, and would often result in doctors taking patients off the drugs.

But the latest research, published in the journal Kidney International, shows this isn’t always the case.

The study analyzed data from 125,000 U.S. patients using proton pump inhibitors and found more than half who went on to develop chronic kidney damage had no prior acute kidney problems.

The study also found that people using proton pump inhibitors had, on average, a 20 percent increase in developing chronic kidney disease compared with those taking H2 blockers such as Zantac or Pepcid. Those medications also reduce the production of stomach acid and are available over the counter.

It’s not the first time that proton pump inhibitors have led to health concerns. Their use has been linked to increased rates of fractures, pneumonia, the gut infection C. difficile, and low vitamin B12 and magnesium levels.

“These drugs should be used at the lowest dose and for the shortest duration appropriate for the condition being treated,” according to Health Canada.

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