Impact of Proton Pomp Inhibitors on Hypomagnesemia and Arterial Stiffness in Renal Transplant Recipients

S. Sezer,¹ B. Gurlek Demirci,¹ M. Erkmen Uyar,¹ S. Uyanik,² M. Haberal.³

¹Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey
²Department of Intrenal Medicine, Baskent University Faculty of Medicine, Ankara, Turkey
³Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.

Meeting: 2015 American Transplant Congress

Abstract number: A185

Keywords: Arteriosclerosis, Metabolic complications, Renal function

Session Information

Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic

Session Type: Poster Session

Date: Saturday, May 2, 2015

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

Purpose: Hypomagnesemia predicts cardiovascular morbidity and mortality in the general population and accelerated loss of kidney function in renal transplant recipients (RTRs). Proton pomp inhibitors (PPIs) or H2 receptor blockers (H2RBs) are frequently used agents after RT. Recent studies highlighted the association between hypomagnesemia and PPIs in healthy population and patients ongoing hemodialysis. The aim of this study was to evaluate the effects of PPIs on serum magnesium levels and arterial stiffness in RTRs.

Materials and Methods: We performed a retrospective study of 354 maintenance RTRs (mean age: 38.6 ± 10.7 years) with stable allograft function who had received their transplant at least 36 months previously. All acute cellular and humoral rejections were excluded. According to using stomach-protecting agents (SPAs), patients were divided in to three groups: PPIs (Group 1, n: 164), H2RBs (Group 2, n: 96) and control group who don't receive SPAs (Group 3, n: 94). Clinical and laboratory parameters (complete blood count, creatinine, calcium, phosphorus, magnesium, vitamin B12, folic acid, lipid profile) were noted from recorded data. Estimated glomerular filtration rate (eGFR) was calculated by using the MDRD4 equation. Pulse wave velocity (PWv) was determined from pressure tracing over carotid and femoral arteries using the SphygmoCor system.

Results: Groups were similar in means of demographic characteristics and biochemical parameters. Mean serum magnesium levels were significantly lower in group 1, however similar in group 2 and 3 (1.5 ± 0.04 mg/dl, 1.7 ± 0.02 mg/dl and 1.7 ± 0.01 mgdl, respectively). PWv values were significantly higher in group 1, whereas similar in group 2 and 3 (7.3 ± 0.2 cm/sec, 6.3 ± 0.1cm/sec and 6.2 ± 0.1 cm/sec, retrospectively). In linear regression analysis; type of SPAs (p: 0.001), serum calcium (p: 0.031), magnesium (p: 0.07) and folic acid levels (p: 0.013) were detected as the predictors of PWv.

Conclusion: We concluded that PPIs inhibit magnesium absorbtion independent from calcium metabolism in RTRs. Moreover, PPIs leads to increased arterial stiffness and cardiovascular risk in RTRs. Thus physicians should be aware of the side effects of PPIs to scale down the cardiovascular morbidity and mortality.

To cite this abstract in AMA style:

Sezer S, Demirci BGurlek, Uyar MErkmen, Uyanik S, Haberal M. Impact of Proton Pomp Inhibitors on Hypomagnesemia and Arterial Stiffness in Renal Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-proton-pomp-inhibitors-on-hypomagnesemia-and-arterial-stiffness-in-renal-transplant-recipients/. Accessed May 7, 2025.

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