scholarly journals Proton-Pump Inhibitors and Hypomagnesaemia in Kidney Transplant Recipients

2019 ◽  
Vol 8 (12) ◽  
pp. 2162 ◽  
Author(s):  
Rianne M. Douwes ◽  
António W. Gomes-Neto ◽  
Joëlle C. Schutten ◽  
Else van den Berg ◽  
Martin H. de Borst ◽  
...  

Proton-pump inhibitors (PPIs) are commonly used after kidney transplantation and there is rarely an incentive to discontinue treatment. In the general population, PPI use has been associated with hypomagnesaemia. We aimed to investigate whether PPI use is associated with plasma magnesium, 24-h urinary magnesium excretion and hypomagnesaemia, in kidney transplant recipients (KTR). Plasma magnesium and 24-h urinary magnesium excretion were measured in 686 stable outpatient KTR with a functioning allograft for ≥1 year from the TransplantLines Food and Nutrition Biobank and Cohort-Study (NCT02811835). PPIs were used by 389 KTR (56.6%). In multivariable linear regression analyses, PPI use was associated with lower plasma magnesium (β: −0.02, P = 0.02) and lower 24-h urinary magnesium excretion (β: −0.82, P < 0.001). Moreover, PPI users had a higher risk of hypomagnesaemia (plasma magnesium <0.70 mmol/L), compared with non-users (Odds Ratio (OR): 2.12; 95% confidence interval (CI) 1.43–3.15, P < 0.001). This risk tended to be highest among KTR taking high PPI dosages (>20 mg omeprazole Eq/day) and was independent of adjustment for potential confounders (OR: 2.46; 95% CI 1.32–4.57, P < 0.005). No interaction was observed between PPI use and the use of loop diuretics, thiazide diuretics, tacrolimus, or diabetes (Pinteraction > 0.05). These results demonstrate that PPI use is independently associated with lower magnesium status and hypomagnesaemia in KTR. The concomitant decrease in urinary magnesium excretion indicates that this likely is the consequence of reduced intestinal magnesium absorption. Based on these results, it might be of benefit to monitor magnesium status periodically in KTR on chronic PPI therapy.

2019 ◽  
Vol 9 (2) ◽  
pp. 35-47 ◽  
Author(s):  
Boonphiphop Boonpheng ◽  
Charat Thongprayoon ◽  
Tarun Bathini ◽  
Konika Sharma ◽  
Michael A Mao ◽  
...  

2014 ◽  
Vol 97 (5) ◽  
pp. 518-524 ◽  
Author(s):  
John P. Knorr ◽  
Mariel Sjeime ◽  
Leonard E. Braitman ◽  
Pankaj Jawa ◽  
Radi Zaki ◽  
...  

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii730-iii730 ◽  
Author(s):  
Omer Uludag ◽  
Safak Mirioglu ◽  
Ahmet Dirim ◽  
Omer Akardere ◽  
Arif Akyildiz ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document