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Proton pump inhibitors linked to hypomagnesemia: a systematic review and meta-analysis of observational studies

Wisit Cheungpasitporn1, Charat Thongprayoon1, Wonngarm Kittanamongkolchai1

  • 1a Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA .

Renal Failure
|June 26, 2015
PubMed
Abstract

Insights

Proton pump inhibitor (PPI) use is linked to a higher risk of hypomagnesemia. This meta-analysis confirms a significant association, suggesting careful monitoring for patients on long-term PPI therapy.

Area of Science:

  • Pharmacology
  • Gastroenterology
  • Nephrology

Background:

  • Conflicting reports exist regarding the risk of hypomagnesemia in patients using proton pump inhibitors (PPIs).
  • This meta-analysis aimed to clarify the association between PPI usage and hypomagnesemia risk.

Purpose of the Study:

  • To systematically evaluate the association between proton pump inhibitor (PPI) use and the risk of developing hypomagnesemia.
  • To provide a quantitative assessment of this risk based on existing observational studies.

Main Methods:

  • A comprehensive literature search was conducted across major databases (MEDLINE, EMBASE, Cochrane) up to September 2014.
  • Included studies reported odds ratios or hazard ratios for hypomagnesemia in PPI users.
  • A random-effects model was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs).

Main Results:

  • Nine observational studies, encompassing 109,798 patients, were analyzed.
  • The overall pooled RR for hypomagnesemia in PPI users was 1.43 (95% CI, 1.08-1.88).
  • Sensitivity analysis of high-quality studies (Newcastle-Ottawa score ≥ 8) showed a significant RR of 1.63 (95% CI, 1.14-2.23).

Conclusions:

  • Proton pump inhibitor use is associated with a statistically significant increased risk of hypomagnesemia.
  • This finding suggests PPIs may impact the clinical management of patients at risk for hypomagnesemia-related cardiovascular events.
Keywords:
Electrolytehypomagnesemiamagnesiummeta-analysisproton pump inhibitors

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