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Is there a correlation between hypomagnesemia linked to long-term proton pump inhibitor use and the active agent?

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Summary

Background

One of the electrolyte disorders considered to be linked to proton pump inhibitors (PPI) use is hypomagnesemia. The aim of this study was to assess the incidence of hypomagnesemia linked to long-term PPI use and the correlation with active agents.

Methods

The study included 305 patients aged over 18 years with PPI use of 1 year or longer and attending the internal diseases clinic for any reason from April 2019 to December 2019. A survey study was performed about the demographic characteristics and PPI use of patients. Laboratory parameters, such as the hemogram, magnesium, phosphorus, calcium and vitamin B12 concentrations were recorded. Magnesium concentrations were measured by a colorimetric method.

Results

Of the patients 140 (45.9%) were female and 165 (54.1%) were male. The most commonly used PPI active agent was pantoprazole. The duration of PPI use varied from 1–25 years with a mean of 4.31 ± 4.52 years. Of the patients 51.5% reported no medication side effects. The most commonly observed side effect was constipation (n = 98, 32.1%). The mean magnesium concentration was 1.95 ± 0.02 mg/dL. Hypomagnesemia was identified in 65 (21.3%) patients and the incidence increased as age and duration of use increased. Patients using omeprazole had significantly lower magnesium levels compared to patients using pantoprazole, rabeprazole, esomeprazole and lansoprazole.

Conclusion

In light of the data obtained it was concluded that hypomagnesemia linked to PPI use is associated with the type of PPI. While patients using rabeprazole had the lowest rates, those using omeprazole had significantly higher rates of hypomagnesemia. Additionally, there was a proportional correlation between age and duration of use with the risk of development of hypomagnesemia.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Health Sciences Okmeydanı Training and Research Hospital, Istanbul, Turkey

    Şengül Aydın Yoldemir MD, Murat Akarsu & Mustafa Ozcan

  2. Departament of Family Medicine, University of Health Sciences, Istanbul Şişli Hamidiye Etfal Health Practice and Research Center, Istanbul, Turkey

    Guzin Zeren Ozturk

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  1. Şengül Aydın Yoldemir MD
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  2. Guzin Zeren Ozturk
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  3. Murat Akarsu
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Correspondence to Şengül Aydın Yoldemir MD.

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Ş. Aydın Yoldemır, G. Zeren Ozturk, M. Akarsu and M. Ozcan declare that they have no competing interests.

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Aydın Yoldemir, Ş., Zeren Ozturk, G., Akarsu, M. et al. Is there a correlation between hypomagnesemia linked to long-term proton pump inhibitor use and the active agent?. Wien Klin Wochenschr 134, 104–109 (2022). https://doi.org/10.1007/s00508-021-01834-x

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