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The Effect of Omeprazole on Urinary Magnesium Excretion in Children with Peptic Diseases
Fatemeh Famouri1,2, Nirvana Tavahen1,2, Hossein Gholami1,2
1Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Omeprazole treatment in children with peptic disease led to decreased urinary and serum magnesium levels. The kidneys conserve magnesium by reducing excretion, not due to increased urinary loss.
Area of Science:
- Pediatric Gastroenterology
- Clinical Pharmacology
- Nephrology
Background:
- Proton pump inhibitors like omeprazole are widely used for treating acid-related disorders in children.
- Hypomagnesemia is a potential side effect of long-term proton pump inhibitor use.
- The precise mechanism of magnesium (Mg) dysregulation during omeprazole therapy in pediatric populations requires further elucidation.
Purpose of the Study:
- To investigate the impact of omeprazole on urinary magnesium excretion in children with peptic disease.
- To determine if altered fractional excretion of magnesium contributes to hypomagnesemia in this cohort.
Main Methods:
- A single-arm clinical trial involving 44 children with acid peptic disease treated with omeprazole (1-2 mg/kg/day) for 3 months.
- Serum and urine magnesium and creatinine levels were measured pre- and post-intervention.
- Fractional excretion of magnesium was calculated using standard formulas.
Main Results:
- Significant decreases in mean urinary magnesium levels (4.96 to 1.46 mg/dL) and serum magnesium levels (1.90 to 1.37 mg/dL) were observed post-omeprazole treatment (P < 0.001 and P < 0.01, respectively).
- Mean fractional excretion of magnesium significantly decreased from 5.2% to 1.7% (P < 0.01).
- Urinary creatinine levels increased significantly (P < 0.001), while serum creatinine showed a non-significant trend of increase (P = 0.053).
Conclusions:
- Omeprazole treatment in children with peptic disease is associated with significant reductions in both serum and urinary magnesium levels.
- The observed hypomagnesemia is not caused by increased urinary magnesium loss.
- Kidney function appears to adapt by decreasing urinary magnesium excretion to conserve magnesium during omeprazole therapy.
Objective:
This study investigates the impact of omeprazole on urinary magnesium (Mg) excretion in children undergoing treatment for peptic disease. Specifically, it examines how omeprazole influences the fractional excretion of Mg.
Methods:
This single-arm clinical trial was conducted from 2020 to 2021. With 44 children diagnosed with acid peptic disease who received omeprazole (1-2 mg/kg/day) for 3 months at the Gastroenterology Clinic of Imam Hossein Hospital, Isfahan, Iran. Serum and urine levels of Mg and creatinine were measured before and after the intervention using the Pars Azmoon Kit, following the kits guidelines. The fractional excretion of Mg was then calculated using standard formulas.
Findings:
The mean urinary Mg levels decreased significantly from 4.96 ± 2.48 mg/dL before treatment to 1.46 ± 0.63 mg/dL after treatment (P < 0.001). Serum Mg levels also significantly declined from 1.90 ± 0.20 mg/dL before treatment to 1.37 ± 0.03 mg/dL after treatment (P < 0.01). The mean fractional excretion of Mg decreased from 5.2% ± 1.2% before therapy to 1.7% ± 0.63% after treatment (P < 0.01). Serum creatinine levels showed a slight increase from 0.62 ± 0.19 mg/dL to 0.67 ± 0.13 mg/dL (P = 0.053), whereas urinary creatinine levels increased by 20.80 ± 18.77 mg/dL (P < 0.001).
Conclusion:
The observed hypomagnesemia is not attributable to increased urinary Mg loss. Instead, the kidneys appear to compensate for the reduced serum Mg levels by decreasing urinary Mg excretion, thereby conserving Mg in the body following omeprazole treatment.
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