Inhibition of Gastric Secretion by Omeprazole and Efficiency of Calcium Carbonate on the Control of Hyperphosphatemia in Patients on Chronic Hemodialysis

Hardy, Peter; Séchet, A.; Hottelart, C; Oprisiu, Roxana; Abighanem, O.; Saïd, S; Rasombololona, M.; Brazier, Michel; Morinière, P.; Achard, Jean‐Michel; Pruna, A; Fournier, A

doi:10.1046/j.1525-1594.1998.06200.x

Cited by 52 publications

(50 citation statements)

References 9 publications

(15 reference statements)

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“…Unfortunately, we did not measure the insulin levels in the current study. Our data seem to confirm the existence of an extrarenal P clearance in HD patients that could be induced by several factors such as: the hungry bone condition, the intermittent dialysis-induced reduction of exchangeable P pool, the insulin-mediated intracellular dietary P transport and physicochemical inverse equilibrium between plasma P and Ca and between plasma P and metabolic acidosis [13]. …”

Section: Discussionsupporting

confidence: 70%

“…However, Hardy et al [13]did not show a decreased binding efficiency of CaCO 3 when patients were on omeprazole treatment. In our uremic patients on RDT we observed a peak of the total plasma calcium levels 30 min after dietary calcium load and the same behavior was confirmed for ionized calcium.…”

Section: Discussionmentioning

confidence: 99%

“…Little attention has been paid to the effects of inhibition of gastric acid secretion with omeprazole on Ca and P absorption in RDT patients. Hardy et al [13]showed that long-term omeprazole administration increases the predialytic P levels, probably by mean of a concomitant decrease of plasma calcium and bicarbonate. The same authors did not show any decrease in the P binding activity of CaCO 3 during omeprazole administration [13].…”

Section: Introductionmentioning

confidence: 99%

“…Hardy et al [13]showed that long-term omeprazole administration increases the predialytic P levels, probably by mean of a concomitant decrease of plasma calcium and bicarbonate. The same authors did not show any decrease in the P binding activity of CaCO 3 during omeprazole administration [13]. In the present study, we compared the Ca and P behaviors in a large group of patients on RDT, without residual renal function, submitted to the same dietary Ca-P overload previously used by us in normal subjects employing the same protocol [11].…”

Section: Introductionmentioning

confidence: 99%

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

Graziani

Badalamenti

Como

et al. 2002

Nephron

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In normal subjects, the gastric ionisation of calcium and phosphate seems to be a prerequisite for their intestinal absorption. We investigated the behavior of the plasma calcium and phosphate profile in 30 patients on regular dialysis treatment in the 6 h following a meal containing 1 g of calcium and 2 g of phosphate. Moreover, to assess the role of gastric acidity, the study was repeated after 3 days on omeprazole administration, to nearly abolish gastric acid secretion. Both total plasma calcium and ionized calcium peaked after the meal (at 30 and 120 min, respectively) only in basal study, while no peak was observed after the administration of omeprazole. Surprisingly, both in basal and in the omeprazole study the levels of plasma phosphate did not increase after the test meal. In conclusion, as in normal subjects, the gastric ionization of dietary calcium promotes the intestinal absorption of calcium in uremic patients on dialysis treatment, while the acute gastric acid inhibition by omeprazole reduced the intestinal calcium transport. In contrast, with the ‘trade off’ hypothesis we did not observe any postprandial phosphate peak after the dietary load, and, in contrast with normal subjects, omeprazole administration did not influence the phosphate profile.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Graziani

Badalamenti

Como

et al. 2002

Nephron

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“…There is an emerging concern about chronic PPI therapy and the risk of fragility fractures [45,102,108]. One potential mechanism by which PPIs may affect fracture incidence is by impairing intestinal calcium absorption [46,47,75]. Without an acidic environment in the stomach and upper small bowel, calcium may be retained in the food matrix, preventing absorption [82].…”

Section: The Effect Of Drugs On Bone Qualitymentioning

confidence: 99%

Diseases Affecting Bone Quality: Beyond Osteoporosis

Unnanuntana

Rebolledo

Khair

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Bone quantity, quality, and turnover contribute to whole bone strength. Although bone mineral density, or bone quantity, is associated with increased fracture risk, less is known about bone quality. Various conditions, including disorders of mineral homeostasis, disorders in bone remodeling, collagen disorders, and drugs, affect bone quality. Questions/purposes The objectives of this review are to (1) identify the conditions and diseases that could adversely affect bone quality besides osteoporosis, and (2) evaluate how these conditions influence bone quality. Methods We searched PubMed using the keywords ''causes'' combined with ''secondary osteoporosis'' or ''fragility fracture.'' After identifying 20 disorders/conditions, we subsequently searched each condition to evaluate its effect on bone quality. Results Many disorders or conditions have an effect on bone metabolism, leading to fragility fractures. These disorders include abnormalities that disrupt mineral homeostasis, lead to an alteration of the mineralization process, and ultimately reduce bone strength. The balance between bone formation and resorption is also essential to prevent microdamage accumulation and maintain proper material and structural integrity of the bone. As a result, diseases that alter the bone turnover process lead to a reduction of bone strength. Because Type I collagen is the most abundant protein found in bone, defects in Type I collagen can result in alterations of material property, ultimately leading to fragility fractures. Additionally, some medications can adversely affect bone. Conclusions Recognizing these conditions and diseases and understanding their etiology and pathogenesis is crucial for patient care and maintaining overall bone health.

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Proton Pump Inhibitor Use, Hip Fracture, and Change in Bone Mineral Density in Postmenopausal Women

et al. 2010

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Background Proton pump inhibitor (PPI) medications have been inconsistently shown to be associated with osteoporotic fractures. The objective was to examine the association of PPI use with bone outcomes (fracture, bone mineral density [BMD]) Methods This prospective analysis included 161,806 postmenopausal women ages 50 to 79 years without history of hip fracture enrolled in the Women’s Health Initiative (WHI) Observational Study and Clinical Trials with a mean (SD) follow-up of 7.8 (1.6) years. Analyses were conducted on 130,487 women with complete information. Medication information was taken directly from drug containers during in-person interviews (baseline, year 3). Main outcome measures were self-reported fractures (hip [adjudicated], clinical spine, lower arm or wrist, and total fractures) and for a subsample (3 densitometry sites), 3-year change in BMD. Results During 1,005,126 person-years of follow-up, 1500 hip fractures, 4881 lower arm or wrist fractures, 2315 clinical spine fractures and 21247 total fractures occurred. The multivariate-adjusted hazard ratios for current PPI use were 1.00 (95% CI, 0.71 to 1.40) for hip fracture, 1.47 (CI 1.18–1.82) for clinical spine fracture, 1.26 (CI, 1.05 to 1.51) for lower arm or wrist fracture, and 1.25 (CI, 1.15 to 1.36) for total fractures. BMD measurements did not vary between PPI users and nonusers at baseline. PPI use was associated with only a marginal effect on 3-year BMD change at the hip (p=0.05) but not at other sites. Conclusion PPI use was not associated with hip fractures, but was modestly associated with clinical spine, lower arm or wrist and total fractures.

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Inhibition of Gastric Secretion by Omeprazole and Efficiency of Calcium Carbonate on the Control of Hyperphosphatemia in Patients on Chronic Hemodialysis

Cited by 52 publications

References 9 publications

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

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

Diseases Affecting Bone Quality: Beyond Osteoporosis

Proton Pump Inhibitor Use, Hip Fracture, and Change in Bone Mineral Density in Postmenopausal Women

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