Proton pump inhibitor use and its relation to serum magnesium levels among hemodialysis patients: A single centre study in a South Indian tertiary care hospital

Introduction: Proton pump inhibitors (PPI) are commonly used in clinical practice for various indications such as gastritis, peptic ulcer and gastroesophageal reflux disease. In Observational studies, Hypomagnesaemia has been associated with PPI use in general population. Hypomagnesaemia is a significant predictor of mortality especially in HD patients. There is a lack of data regarding association of PPI with hypomagnesemia in dialysis population. Materials and Method: Study was conducted in Tertiary care hospital using a pre dialysis serum samples by colorimetric-kit method. Mean of two consecutive serum Mg levels measured at 6 weeks interval was calculated for further analysis. Clinical, demographic data along with duration of PPI use in months were recorded. Patients on diuretics, chronic diarrhoea and HD for Acute Kidney Injury were excluded. Student t-test was used for comparison between PPI users and non users.single-centre observational design on 87 prevalent HD patients on twice weekly and thrice weekly maintenance HD with regular PPI use for >2 weeks. Serum Magnesium (Mg) level was determined using Results:55 patients were on Proton Pump Inhibitors at the time of study. All patients were dialyzed with dialysate Mg of 1.2mg/dL (0.7 mmol/L). Average duration of PPIs use was 6 months (6± 1.45 months). Serum Mg levels among PPI users was 2.5 mg/dL and non-users was 2.4 mg/dL. No correlation was found between serum Mg levels and duration of PPIs use (p > 0.8). Conclusion: In our study we did not find any association between hypomagnesemia and PPI use in hemodialysis patients. As our study was single centered, small population with short follow up, further well defined long term Randomized controlled trials on Mg levels with PPI use are needed.