Effect of Chronic Proton Pump Inhibitor Use on Serum Magnesium Levels inPediatric Patients

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Authors

  • Amy Stanford Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA
  • Riad Rahhal Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA; Division of Pediatric Gastroenterology, University of Iowa, Iowa City, IA 52242, USA

DOI:

https://doi.org/10.17140/GOJ-1-118

Keywords:

Hypomagnesemia, Proton pump inhibitor, Children

Abstract

Hypomagnesemia has been reported in adult patients on Proton Pump Inhibitor (PPI) therapy. No studies have described the effect of this class on medications on Magnesium (Mg) levels in children. This was a retrospective cohort study assessing serum Mg levels in patients on PPI therapy followed by a pediatric gastroenterology service at a tertiary center. The study included 31 patients with a mean age of 7.8 years with 74 serum Mg levels. Duration of PPI therapy ranged between few days to more than 8 years. The main indication for PPI therapy was gastroesophageal reflux disease. Only 2 patients, of adult age, had Mg levels below the normal reference limit of 1.6 mg/dL. In one patient, multiple risk factors for hypomagnesemia were noted. For the entire cohort, there was no statistically significant difference in serum Mg levels  over time or with chronic use (defined as more than 2 years). This study did not identify any patient less than 18 years of age with hypomagnesemia while on PPI therapy. Prospective larger long-term pediatric studies may still be needed to better assess the incidence of hypomagnesemia in children on PPI therapy.

References

Hassall E, Israel D, Shepherd R, et al. Omeprazole for treat-ment of chronic erosive esophagitis in children: a multicenter study of efficacy, safety, tolerability and dose requirements. In-ternational Pediatric Omeprazole Study Group. J Pediatr. 2000; 137(6): 800-807. doi: 10.1067/mpd.2000.109607

Markovits N, Loebstein R, Halkin H, et al. The association of proton pump inhibitors and hypomagnesemia in the community setting. J Clin Pharmacol. 2014; 54(8): 889-895. doi: 10.1002/ jcph.316

Koulouridis I, Alfayez M, Tighiouart H, et al. Out-of-hospital use of proton pump inhibitors and hypomagnesemia at hospital admission: a nested case-control study. Am J Kidney Dis. 2013; 62(4): 730-737. doi: 10.1053/j.ajkd.2013.02.373

Danziger J, William JH, Scott DJ, et al. Proton-pump inhibi-tor use is associated with low serum magnesium concentrations. Kidney Int. 2013; 83(4): 692-699. doi: 10.1038/ki.2012.452

Faulhaber GA, Ascoli BM, Lubini A, et al. Serum magne-sium and proton-pump inhibitors use: a cross-sectional study. Rev Assoc Med Bras. 2013; 59(3): 276-279. doi: 10.1016/j. ramb.2012.12.007

Lindner G, Funk GC, Leichtle AB, et al. Impact of proton pump inhibitor use on magnesium homoeostasis: a cross-sec-tional study in a tertiary emergency department. Int J Clin Pract. 2014; 68(11): 1352-1357. doi: 10.1111/ijcp.12469

Toh JW, Ong E, Wilson R. Hypomagnesaemia associated with long-term use of proton pump inhibitors. Gastroenterol Rep (Oxf). 2015; 3(3): 243-253. doi: 10.1093/gastro/gou054

Mackay JD, Bladon PT. Hypomagnesaemia due to proton-pump inhibitor therapy: a clinical case series. QJM. 2010; 103(6): 387-395. doi: 10.1093/qjmed/hcq021

Hess MW, Hoenderop JG, Bindels RJ, et al. Systematic re-view: hypomagnesaemia induced by proton pump inhibition. Al-iment Pharmacol Ther. 2012; 36: 405-413. doi: 10.1111/j.1365- 2036.2012.05201.x

Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of proton-pump inhibitors. Clin Endocrinol (Oxf). 2008; 69(2): 338-341. doi: 10.1111/j.1365-2265.2008.03194.x

Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypo-chlorhydria from short-term omeprazole treatment does not in-hibit intestinal absorption of calcium, phosphorus, magnesium or zinc from food in humans. J Am Coll Nutr. 1995; 14(4): 364- 368. doi: 10.1080/07315724.1995.10718522

Thongon N, Krishnamra N. Apical acidity decreases inhibi-tory effect of omeprazole on Magnesium (2+) absorption and claudin-7 and -12 expression in Caco-2 monolayers. Exp Mol Med. 2012; 44: 684-693.

Published

2015-10-13

How to Cite

Amy Stanford, & Riad Rahhal. (2015). Effect of Chronic Proton Pump Inhibitor Use on Serum Magnesium Levels inPediatric Patients. Gastro, 1(4), 107–110. https://doi.org/10.17140/GOJ-1-118