Calcium and Phosphate Plasma Levels in Dialysis Patients after Dietary Ca-P Overload

Graziani, G.; Badalamenti, Salvatore; Como, Giovanna; Gallieni, Maurizio; Finazzi, Silvia; Angelini, Claudio; Brancaccio, Diego; Ponticelli, Claudio

doi:10.1159/000064290

Cited by 59 publications

(51 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the only studies that have demonstrated decreased calcium absorption among PPI users have been those that specifically assessed absorption of supplemental calcium carbonate in fasting individuals (26,27). In all other scenarios using different formulations of supplemental calcium or calcium ingestion associated with meals, no effects of PPIs on calcium absorption have been shown (33)(34)(35). It remains possible, nevertheless, that very marginal decrements in net calcium absorption may, over long periods of time, induce a large enough net calcium loss to cause clinically meaningful reductions in BMD (36).…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Proton Pump Inhibitor Use and Longitudinal Change in Bone Mineral Density: A Population-Based From the Canadian Multicentre Osteoporosis Study (CaMos)

Targownik

Leslie²,

Davison³

et al. 2012

American Journal of Gastroenterology

119

View full text Add to dashboard Cite

OBJECTIVES-Proton pump inhibitor (PPI) use has been identified as a risk factor for hip and vertebral fractures. Evidence supporting a relationship between PPI use and osteoporosis remains Correspondence: Laura E. Targownik, MD, MSHS, Gastroenterology, University of Manitoba, 805G-715 McDermot Avenue, Winnipeg, Manitoba, Canada R3E 3P4. targowni@cc.umanitoba.ca. 8 See Appendix. CONFLICT OF INTERESTGuarantor of the article: Laura E. Targownik, MD, MSHS. Specific author contributions: study concept and design, acquisition of database data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, and statistical analysis: Laura E. Targownik and William D. Leslie; acquisition of participant data, study concept and design, drafting of the manuscript, and critical revision of the manuscript for important intellectual content: K. Shawn Davison, David Goltzman, Sophie A. Jamal, Nancy Kreiger, Robert G. Josse, Stephanie M. Kaiser, Chris S. Kovacs, and Jerilynn C. Prior; acquisition of database data and statistical analysis: Wei Zhou. CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript scant. Demonstrating that PPIs are associated with accelerated bone mineral density (BMD) loss would provide supportive evidence for a mechanism through which PPIs could increase fracture risk.METHODS-We used the Canadian Multicentre Osteoporosis Study data set, which enrolled a population-based sample of Canadians who underwent BMD testing of the femoral neck, total hip, and lumbar spine (L1-L4) at baseline, and then again at 5 and 10 years. Participants also reported drug use and exposure to risk factors for osteoporosis and fracture. Multivariate linear regression was used to determine the independent association of PPI exposure and baseline BMD, and on change in BMD at 5 and 10 years.RESULTS-In all, 8,340 subjects were included in the baseline analysis, with 4,512 (55%) undergoing year 10 BMD testing. After adjusting for potential confounders, PPI use was associated with significantly lower baseline BMD at the femoral neck and total hip. PPI use was not associated with a significant acceleration in covariate-adjusted BMD loss at any measurement site after 5 and 10 years of follow-up.CONCLUSIONS-PPI users had lower BMD at baseline than PPI non-users, but PPI use over 10 years did not appear to be associated with accelerated BMD loss. The reasons for discordant findings between PPI use at baseline and during follow-up require further study.

show abstract

Section: Discussionmentioning

confidence: 99%

The Relationship Between Proton Pump Inhibitor Use and Longitudinal Change in Bone Mineral Density: A Population-Based From the Canadian Multicentre Osteoporosis Study (CaMos)

Targownik

Leslie²,

Davison³

et al. 2012

American Journal of Gastroenterology

119

View full text Add to dashboard Cite

show abstract

“…Several studies have tried to evaluate the importance of acid for calcium absorption. Four out of five studies found a decreased absorption of calcium in older patients on PPI therapy [16,17,18,19,20]. …”

Section: Effects Of Ppis On Absorption Of Minerals and Vitaminsmentioning

confidence: 99%

Long-Term Acid Inhibition: Benefits and Harms

Tepeš

2011

Dig Dis

View full text Add to dashboard Cite

Proton pump inhibitors (PPIs) are the drugs of choice in the therapy of acid-related disorders. PPIs are as a class remarkably safe. Serious adverse events such as acute interstitial nephritis are extremely rare. Some reports in recent years have placed some concern on the long-term use of PPIs. Long-term therapy with PPIs can cause hypochlorhydria, hypergastrinemia and has interactions on hepatic cytochrome P450 enzymes which might increase the risk of infectious complications, nutritional deficiencies and drug-drug interactions. The vast majority of data came from retrospective case-control or cohort studies which are prone to confounders. At the moment we cannot conclude that long-term PPI use causes anemia, osteoporosis and bone fractures, increases the risk for pulmonary or enteric infections, has an effect on GUT mucosa, polyp or tumor formation, or that PPI use increases the risk of cardiovascular events in patients on PPIs and clopidogrel. We need prospective randomized trials to be able to definitely answer the questions raised in epidemiologic studies. Maintenance therapy with PPIs should be started only if strict indications for that therapy are fulfilled.

show abstract

“…Two studies by Graziani et al (one using eight healthy males and the other with 30 dialysis patients) using omeprazole 20 mg every 8 hours for 3 days showed the lack of a postprandial increase in calcium, suggesting a decrease in calcium absorption [590,591]. O'Connell et al studied 18 postmenopausal women taking omeprazole 20 mg for 7 days and found a 41% decrease in calcium absorption of radioactive labeled calcium carbonate in the fasting state [592].…”

Section: Proton Pump Inhibitors (Ppis)mentioning

confidence: 99%