Effect of low‐dose proton pump inhibitor on preventing upper gastrointestinal bleeding in chronic kidney disease patients receiving aspirin

Lim, Hyun; Kim, Jong Hyeok; Baik, Gwang Ho; Park, Ji Won; Kang, Ho Suk; Moon, Sung Hoon; Park, Choong Kee

doi:10.1111/jgh.12780

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…In addition, HD patients usually have several comorbidities, such as ischemic heart disease, cerebral infarction, and peripheral arterial disease, and these diseases result in a high prevalence of ESRD patients taking antiplatelet drugs [ 24 ]. As a result, PPIs are administered to ESRD patients prophylactically to prevent gastrointestinal bleeding [ 25 ]. According to data from the Dialysis Outcomes and Practice Patterns Study (DOPPS), the proportion of patients prescribed either a PPI or an H2 receptor antagonist was 36–38%, with a concomitant increase in the use of PPIs [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Proton Pump Inhibitor Use and Magnesium Concentrations in Hemodialysis Patients: A Cross-Sectional Study

et al. 2015

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Magnesium concentration is a proven predictor of mortality in hemodialysis patients. Recent reports have indicated that proton pump inhibitor (PPI) use affects serum magnesium levels, however few studies have investigated the relationship between PPI use and magnesium levels in hemodialysis patients. This study aimed to clarify the association between PPI use and serum magnesium levels in hemodialysis patients. We designed this cross sectional study and included 1189 hemodialysis patients in stable condition. Associations between PPI and magnesium-related factors, as well as other possible confounders, were evaluated using a multiple regression model. We defined hypomagnesemia as a value < 2.0 mg/dL, and created comparable logistic regression models to assess the association between PPI use and hypomagnesemia. PPI use is associated with a significantly lower mean serum magnesium level than histamine 2 (H2) receptor antagonists or no acid-suppressive medications (mean [SD] PPI: 2.52 [0.45] mg/dL; H2 receptor antagonist: 2.68 [0.41] mg/dL; no acid suppressive medications: 2.68 [0.46] mg/dL; P = 0.001). Hypomagnesemia remained significantly associated with PPI (adjusted OR, OR: 2.05; 95% CI: 1.14–3.69; P = 0.017). PPI use is associated with an increased risk of hypomagnesemia in hemodialysis patients. Future prospective studies are needed to explore magnesium replacement in PPI users on hemodialysis.

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Section: Discussionmentioning

confidence: 99%

Proton Pump Inhibitor Use and Magnesium Concentrations in Hemodialysis Patients: A Cross-Sectional Study

et al. 2015

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“…Hyun Lim et al studied the use of half the standard PPI dose to prevent upper GI bleeding in patients with chronic renal failure undergoing dialysis. The results showed that the incidence and risk of upper GI bleeding were significantly reduced in the prevention group compared to the nonprevention group (5.4% vs. 1.4%) [ 6 ]. This study to some extent indicated that half the conventional dose of PPI could still effectively prevent upper gastrointestinal bleeding, which was consistent with our study.…”

Section: Discussionmentioning

confidence: 99%

“…It is presumed that reducing the dose of PPIs may reduce the adverse effects of long-term use of PPIs. Ally MR et al found that giving half of the normal dose of PPIs to patients with chronic renal disease effectively prevented GI bleeding [ 6 ]. Based on the above research, we studied the optimal degree of PPI dose reduction, which can not only effectively prevent NSAIDs-related GI bleeding but also reduce the adverse reactions of long-term use of PPIs.…”

Section: Introductionmentioning

confidence: 99%

Omeprazole taken once every other day can effectively prevent aspirin-induced gastrointestinal mucosal damage in rats

Weng,

Song,

Kuai

et al. 2024

BMC Gastroenterol

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Background Proton-pump inhibitors (PPIs) prevent aspirin-associated gastric and duodenal mucosal damage. However, long-term use of PPIs can lead to various adverse reactions, such as gastric polyps and enterochromaffin-like cell hyperplasia. Current research indicates that the abovementioned adverse reactions are mainly related to hypergastrinemia. We investigated whether low-frequency administration of omeprazole could effectively repair aspirin-induced mucosal damage and reduce the increase in gastrin levels associated with long-term use of PPIs. Methods Sprague‒Dawley rats were divided into four treatment groups: daily aspirin, daily aspirin and omeprazole once every day (qd), daily aspirin and omeprazole once every other day (qod), and daily aspirin and omeprazole once every three days (1/d3). After 15 days of feeding, blood samples were collected, and the stomachs of sacrificed rats were subjected to macroscopic, histological, and immunohistochemical studies. Moreover, in clinical practice, patients with peptic ulcers caused by aspirin took a standard dose of omeprazole (20 mg) every other day. Two months later, gastroscopy was performed to examine the healing of the ulcers. Results Both the omeprazole qd and omeprazole qod administrations effectively prevented aspirin-induced gastric peptic ulcers, with no significant difference between the two groups in the inhibition of parietal cell secretion of gastric acid and cell apoptosis. However, omeprazole 1/d3 failed to completely prevent aspirin-induced gastric mucosal injury. Notably, the gastrin levels, cell proliferation ability and cholecystokinin B receptor expression of the omeprazole qd group were significantly higher than those of the omeprazole qod group. In clinical work, patients with peptic ulcers caused by aspirin were given a standard dose of omeprazole every other day, and their ulcers healed after 2 months, as observed by gastroscopy. Conclusions Omeprazole administration once every other day can effectively prevent aspirin-induced peptic ulcers and reduce hypergastrinemia, which may reduce the long-term adverse effects of PPI treatment.

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Cardiac Pre-operative Evaluation as an Opportunity to Optimize Risk Factors in Kidney Transplant Candidates

Ardati¹

2017

Cardio-Nephrology

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Effect of low‐dose proton pump inhibitor on preventing upper gastrointestinal bleeding in chronic kidney disease patients receiving aspirin

Abstract: Prophylactic low-dose PPI can reduce the risk of non-variceal UGIB in dialysis patients receiving aspirin.

Cited by 5 publications

References 22 publications

Proton Pump Inhibitor Use and Magnesium Concentrations in Hemodialysis Patients: A Cross-Sectional Study

Proton Pump Inhibitor Use and Magnesium Concentrations in Hemodialysis Patients: A Cross-Sectional Study

Omeprazole taken once every other day can effectively prevent aspirin-induced gastrointestinal mucosal damage in rats

Cardiac Pre-operative Evaluation as an Opportunity to Optimize Risk Factors in Kidney Transplant Candidates

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