THE EFFECTS OF CALCIUMCARBONATE/MAGNESIUM CARBONATE COMBINATION CHEWABLE TABLETS IN COMPARISON TO CALCIUM CARBONATE TABLETS ON PHOSPHATE BINDING IN HEMODIALYSIS PATIENTS WHO ARE TAKING PROTON PUMP INHIBITORS

Introduction: Proton-pump inhibitors (PPIs) are a class of drugs which decrease gastric acid production, their overuse is becoming increasingly common. Purpose: The aim of this study was to evaluate medical indications for PPIs in a cohort of prevalent hemodialysis (HD) patients and their awareness about the medical effects of these drugs. Materials and methods: The study was performed in 78 HD patients enrolled in a chronic dialysis program in a single academic dialysis unit. The study was based on medical history obtained from the patients (survey about drugs they take with intention of revealing PPIs, indications for the treatment, their awareness of the mechanism of action of these drugs).Results: 46 patients (59%) took or have been taking PPIs. Almost half (49%; n=22) had no clear medical indications for the drugs. Prescription of PPIs without medical indications was more common among nephrologists (27%), when compared with gastroenterologists (5%; p<0.05). Only 29% (n=13) of patients taking PPIs were aware of the mechanism of action of the drugs. Conclusions: Results of this study reveal the problem of PPI overuse among HD patients. Gastroenterologists usually prescribed PPIs according to medical indications. Lack of patients’ knowledge about the indications for PPI therapy is overwhelming.

Download Full-text

Hypomagnesemia in hemodialysis patients taking proton pump inhibitors

Journal of Fatima Jinnah Medical University ◽

10.37018/dezk2659 ◽

2020 ◽

Vol 14 (2) ◽

pp. 55-58

Author(s):

Abdul Malik ◽

Syed Mohkumuddin ◽

Humaira Rahim ◽

Shamima Hanif

Keyword(s):

Proton Pump Inhibitors ◽

Proton Pump ◽

Serum Magnesium ◽

Cross Sectional Study ◽

Hemodialysis Patients ◽

Mean Value ◽

Female Dominance ◽

P Value ◽

Cross Sectional ◽

The Mean

Background: Proton pump inhibitors (PPIs) are in routine widely prescribed to hemodialysis patients. Recent studies have reported the association of PPIs use with hypomagnesemia in patients with long term hemodialysis. This study aims to determine the frequency of hypomagnesemia in patients of hemodialysis taking proton pump inhibitors. Patients and methods: This cross-sectional study was conducted in the Department of Nephrology of Sandman Provincial Hospital Quetta from 01-6-2019 till 01-9-2019. A total of 120 patients (52 PPI users and 68 non-PPI users) who were on HD for more than 06 months were included. Data regarding age, gender, duration of hemodialysis and taking PPIs were collected. Determination of serum magnesium was made by taking 3 different samples at 2 weeks’ interval and the mean value of serum magnesium was calculated. Serum Mg2+ levels <2.0 mg/dL was taken as hypomagnesemia. A Chi-square test was applied to determine the association of PPI use with hypomagnesemia. Results: Demographic variables such as age and gender were not significantly different between the groups. There was female dominance in both groups (73% in PPI groups and 66.1% in the non-PPI group (p-value 0.65). The mean duration of dialysis was 45.3±13.8 months in PPI users versus 48.9±12.9 months in non-PPI users (p-value 0.14). There was a significantly higher frequency of hypomagnesemia in PPI users; 36 (69.3%) versus 27 (39.7%) in non-PPI users (p-value 0.001). Conclusion: The use of PPI is associated with a significant reduction in serum magnesium levels. So serum magnesium levels should be advised as routine monitoring in patients of hemodialysis taking PPIs.

Download Full-text