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Clinical predictors associated with proton pump inhibitor-induced hypomagnesemia

 Sunyong Kim  ;  Hyuk Lee  ;  Chan Hyuk Park  ;  Choong Nam Shim  ;  Hyun Jik Lee  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Ha Yan Kim  ;  Dae Ryong Kang 
 AMERICAN JOURNAL OF THERAPEUTICS, Vol.22(1) : 14-21, 2015-01 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Agents / administration & dosage ; Antineoplastic Agents / adverse effects ; Carboplatin / administration & dosage ; Carboplatin / adverse effects ; Cisplatin / administration & dosage ; Cisplatin / adverse effects ; Drug Interactions ; Drug Monitoring / methods* ; Female ; Humans ; Magnesium / blood* ; Male ; Middle Aged ; Multivariate Analysis ; Proton Pump Inhibitors / administration & dosage ; Proton Pump Inhibitors / adverse effects* ; Retrospective Studies ; Risk Factors ; Time Factors
There is increasing evidence and case reports regarding proton pump inhibitor (PPI)-induced hypomagnesemia. Our study aimed to clarify the relationship between PPI use and serum magnesium levels and to specify high-risk patients. We retrospectively studied 112 consecutive patients aged 20 years or older who were treated with PPI for ≥30 days and whose serum magnesium levels were available for the PPI treatment period. We compared the mean level of serum magnesium of the enrolled patients with PPI treatment with matched controls. There were no significant differences between the matched PPI users (n = 105) and nonusers (n = 210) in the magnesium levels (0.85 ± 0.09 vs. 0.86 ± 0.16 mM, P = 0.297). In a subgroup analysis of a PPI user group, hypomagnesemia could be observed in 32 patients but not in 80 patients. In multivariate analyses, PPI use for >1 year, age less than 45 years, and concurrent cisplatin or carboplatin use were significantly associated with PPI-induced hypomagnesemia {P = 0.042, odds ratio [OR; 95% confidence interval (CI)]: 5.388 [1.056-27.493]; P = 0.007, OR [95% CI]: 4.710 [1.523-14.571]; P = 0.007, OR [95% CI]: 13.404 [2.066-86.952], respectively} after adjusting for confounders. This study shows that long-term PPI use is associated with hypomagnesemia in hospitalized adult patients. Therefore, serum magnesium levels should be checked before the initiation of PPI treatment and during the treatment period in patients, particularly those concurrently using platinum-based chemotherapy or who are expected to use PPI for long periods.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kang, Dae Ryong(강대용)
Kim, Sun Yong(김선용)
Kim, Ha Yan(김하얀)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Park, Chan Hyuk(박찬혁)
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Shim, Choong Nam(심충남)
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Lee, Hyun Jik(이현직)
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