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Is there a relationship between hypomagnesemia and proton-pump inhibitors in patients on chronic hemodialysis?

I Mikolasevic1, S Milic2, D Stimac2

  • 1Department of Nephrology, Dialysis and Kidney Transplantation, UHC Rijeka, Croatia; Department of Gastroenterology, UHC Rijeka, Croatia.

European Journal of Internal Medicine
|February 25, 2016
PubMed

Insights

Long-term use of proton-pump inhibitors (PPIs) is linked to lower serum magnesium (Mg) levels in patients undergoing chronic hemodialysis (HD). This study highlights a significant association between PPIs and hypomagnesemia in HD patients.

Area of Science:

  • Nephrology
  • Pharmacology
  • Biochemistry

Background:

  • Proton-pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
  • Chronic kidney disease patients, particularly those on hemodialysis (HD), are susceptible to electrolyte imbalances.
  • The impact of long-term PPI use on serum magnesium (Mg) levels in HD patients requires further investigation.

Purpose of the Study:

  • To investigate the association between long-term PPI use and serum Mg levels in chronic HD patients.
  • To explore the potential link between PPI use and cardiovascular (CVD) morbidity in this patient population.

Main Methods:

  • A cohort of 282 chronic HD patients was analyzed, with 170 patients on PPIs.
  • Serum Mg levels were compared between PPI users and non-users.
  • Multivariate analysis was employed to identify independent predictors of low Mg concentrations.

Main Results:

  • Serum Mg levels were significantly lower in PPI users compared to non-users (0.94±0.2 vs. 1.03±0.2 mmol/L; p<0.0001).
  • PPI use was identified as an independent predictor of low serum Mg concentrations (OR 3.05; 95% CI 1.2498-7.4594, p=0.01).
  • No significant association was found between the duration or daily dose of PPIs and Mg levels, nor between residual renal function and Mg concentration.

Conclusions:

  • Long-term PPI use is significantly associated with lower serum Mg levels in chronic HD patients.
  • While a trend was observed, PPI use did not reach statistical significance as a predictor of increased CVD events in this cohort.
  • Further research is warranted to elucidate the clinical implications of PPI-induced hypomagnesemia in HD patients.
Abstract

Keywords:
Chronic hemodialysisProton-pump inhibitorsSerum magnesium

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