Impact of proton pump inhibitor use on magnesium homoeostasis: a cross-sectional study in a tertiary emergency department.

Lindner, G; Funk, G-C; Leichtle, Alexander Benedikt; Fiedler, Martin; Schwarz, Christa; Eleftheriadis, T; Pasch, Andreas; Mohaupt, Markus; Exadaktylos, Aristomenis; Arampatzis, Spyridon (2014). Impact of proton pump inhibitor use on magnesium homoeostasis: a cross-sectional study in a tertiary emergency department. International Journal of Clinical Practice, 68(11), pp. 1352-1357. Wiley 10.1111/ijcp.12469

[img] Text
ijcp12469.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (158kB) | Request a copy

BACKGROUND To date, the use of proton pump inhibitors (PPIs) has been associated with a low risk of hypomagnesaemia and associated adverse outcomes. We hypothesised that a better risk estimate could be derived from a large cohort of outpatients admitted to a tertiary emergency department (ED). METHODS A cross-sectional study was performed in 5118 patients who had measurements of serum magnesium taken on admission to a large tertiary care ED between January 2009 and December 2010. Hypomagnesaemia was defined as a serum magnesium concentration < 0.75 mmol/l. Demographical data, serum electrolyte values, data on medication, comorbidities and outcome with regard to length of hospital stay and mortality were analysed. RESULTS Serum magnesium was normally distributed where upon 1246 patients (24%) were hypomagnesaemic. These patients had a higher prevalence of out-of-hospital PPI use and diuretic use when compared with patients with magnesium levels > 0.75 mmol/l (both p < 0.0001). In multivariable regression analyses adjusted for PPIs, diuretics, renal function and the Charlson comorbidity index score, the association between use of PPIs and risk for hypomagnesaemia remained significant (OR = 2.1; 95% CI: 1.54-2.85). While mortality was not directly related to low magnesium levels (p = 0.67), the length of hospitalisation was prolonged in these patients even after adjustment for underlying comorbid conditions (p < 0.0001). CONCLUSION Use of PPIs predisposes patients to hypomagnesaemia and such to prolonged hospitalisation irrespective of the underlying morbidity, posing a critical concern.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Leichtle, Alexander Benedikt; Fiedler, Martin; Schwarz, Christa; Pasch, Andreas; Mohaupt, Markus; Exadaktylos, Aristomenis and Arampatzis, Spyridon

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1742-1241

Publisher:

Wiley

Language:

English

Submitter:

Barbara Keller

Date Deposited:

01 Apr 2015 16:14

Last Modified:

09 Nov 2015 11:40

Publisher DOI:

10.1111/ijcp.12469

PubMed ID:

24898571

BORIS DOI:

10.7892/boris.65707

URI:

https://boris.unibe.ch/id/eprint/65707

Actions (login required)

Edit item Edit item
Provide Feedback