Document Detail


Proton pump inhibitor omeprazole use is associated with low bone mineral density in maintenance haemodialysis patients.
MedLine Citation:
PMID:  19196364     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Limited studies have shown that proton pump inhibitor (PPI) therapy may decrease bone density or insoluble calcium reabsorption through induction of hypochlorhydria. However, PPI therapy may also reduce bone resorption via inhibition of osteoclastic vacuolar proton pumps. The aim of this study was to determine whether the opposing effects of PPI therapy may cause clinically important alterations in bone mineral densitometry (BMD) parameters in maintenance haemodialysis patients. METHODS: Sixty-eight maintenance haemodialysis patients were enrolled in this study. Patients were classified into two groups involving users of PPI therapy (omeprazole 20 mg/day, group 1, n = 36 patients) and non-users of acid suppression drugs (group 2, n = 32 patients). Patients had radius, hip and spine BMD assessed by dual-energy X-ray absorptiometry. RESULTS: The mean duration of PPI therapy with omeprazole was 27 +/- 5 months. The users of PPI therapy had lower values of bone mineral density and T-scores at the anatomical regions than non-users of acid suppression drugs. Serum calcium and phosphate levels, calcium-phosphate product and serum intact parathormone levels and the ratio of users of vitamin D therapy were similar among groups. A mutivariable adjusted odds ratio for lower bone density associated with more than 18 months of omeprazole, when all the potential confounders were considered, was 1.31 in the proximal radius, 0.982 in the femur neck, 0.939 in the trochanter and 1.192 in the lumbal spine. CONCLUSION: The present data suggest that PPI therapy should be cautiously prescribed in maintenance haemodialysis patients, especially with lower BMD values.
Authors:
A Kirkpantur; B Altun; M Arici; C Turgan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of clinical practice     Volume:  63     ISSN:  1742-1241     ISO Abbreviation:  Int. J. Clin. Pract.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-06     Completed Date:  2010-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9712381     Medline TA:  Int J Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  261-8     Citation Subset:  IM    
Affiliation:
Nephrology Unit, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. alperkirkpantur@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Adult
Aged
Anti-Ulcer Agents / administration & dosage,  adverse effects*
Bone Density / drug effects*
Cross-Sectional Studies
Dose-Response Relationship, Drug
Female
Humans
Kidney Failure, Chronic / complications*,  therapy
Long-Term Care
Male
Middle Aged
Omeprazole / administration & dosage,  adverse effects*
Renal Dialysis*
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents; 73590-58-6/Omeprazole

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