Proton pump inhibitors were associated with lower serum magnesium levels (2.2 mg/dL) compared to non-PPI users (2.6 mg/dL) in dialysis patients, indicating PPI-induced hypomagnesemia.
Observational (n=531)
Does discontinuation of esomeprazole improve serum magnesium levels in a hemodialysis patient with hypomagnesemia?
Discontinuation of proton pump inhibitors rapidly resolves hypomagnesemia in hemodialysis patients, highlighting the importance of regular magnesium monitoring in this population.
Absolute Event Rate: 2.2% vs 2.6%
患者58歳，女性，腎硬化症を原疾患とする慢性腎臓病により7年前に血液透析導入となった．以後週3回の維持透析に通院していた．定期検査で血清マグネシウム1.2 mg/dLと低下を認めた．4年前ごろより緩徐な低下を認め同時期より脳梗塞を合併し2次予防としてクロピドグレルとエソメプラゾールを開始していた．エソメプラゾールによる低マグネシウム血症を疑い中止したところ21日後の定期採血でマグネシウム2.2 mg/dLと改善した．PPIにより腸管からの吸収阻害により低マグネシウム血症が起こるとされる．透析患者は心血管障害の多さから抗血小板薬を内服し同時にPPIを内服していることが多い．そのためPPI内服患者では定期的なマグネシウムの検査が望ましいと考える．
Higuchi et al. (Thu,) conducted a observational in Dialysis patients with end-stage renal disease (n=531). Proton pump inhibitors (PPI) use vs. No PPI use was evaluated on Prevalence of hypomagnesemia induced by proton pump inhibitors. Proton pump inhibitors were associated with lower serum magnesium levels (2.2 mg/dL) compared to non-PPI users (2.6 mg/dL) in dialysis patients, indicating PPI-induced hypomagnesemia.
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