master's thesis
HIipomagnezemija i inhbitori protonske pumpe u pacijenata na kroničnoj hemodijalizi

Ivan Jakopčić (2016)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za internu medicinu
Metadata
TitleHIipomagnezemija i inhbitori protonske pumpe u pacijenata na kroničnoj hemodijalizi
AuthorIvan Jakopčić
Mentor(s)Lidija Orlić (thesis advisor)
Abstract
U ovoj studiji istraţivali smo prevalenciju i povezanost upotrebe IPP-a i vrijednosti serumskog Mg u pacijenata na kroničnoj HD, kao i moguću vezu izmeĎu IPP-a i povećanog rizika od KVB i njima uzrokovanog mortaliteta. Nadalje, zanimalo nas je i je li hipomagnezemija povezana s duljinom uzimanja IPP-a. Od 480 pacijenata koje smo planirali uključiti u istraţivanje 136 ih je isključeno zbog nepotpune medicinske dokumentacije, trajanja nadomjesne bubreţne terapije kraće od 12 mjeseci, upotrebe vezača fosfata baziranih na Mg ili drugih na Mg baziranih lijekova ili laksativa. Od 282 pacijenta uključena u studiju, 170 ih je uzimalo IPP, pri čemu je srednje vrijeme uzimanja IPP-a bilo 26±20 mjeseci. Nije bilo značajne razlike izmeĎu dviju grupa u dobi, trajanju nadomjesne bubreţne terapije, prisutnosti komorbiditeta, upotrebi diuretika, preostaloj bubreţnoj funkciji, hemoglobinu, serumskim albuminima, kaliju, natriju, kalciju, fosfatima, kao ni u vrijednostima iPTH i Kt/V. Vrijednosti serumskog Mg bile su značajno niţe u pacijenata koji primaju IPP, u usporedbi s drugom grupom pacijenata koja ih nije primala (0,94±0,2 vs. 1,03±0,2 mmol/l; p<0,0001). Dnevna doza IPP-a nije pokazala značajnu povezanost s vrijednostima Mg (r=0,106; p=0,167), kao ni srednja duljina njegova uzimanja. Preostala bubreţna funkcija takoĎer nije pokazala značajnu povezanost s razinom Mg (r=-0,102; p=NS) u obje grupe pacijenata. MeĎutim, tijekom perioda praćenja od godinu dana, u usporedbi s pacijentima koji nisu primali IPP, korisnici IPP-a imali su višu stopu teţih KVB, iako ta razlika nije bila statistički značajna (17,6% vs. 10,7%; p=0,110). Pronašli smo značajnu povezanost izmeĎu upotrebe IPP-a i sniţenih vrijednosti serumskog Mg u pacijenata na kroničnoj HD.
Keywordsproton-pump inhibitors serum magnesium chronic hemodialysis
Committee MembersSrđan Novak (committee chairperson)
Goran Hauser (committee member)
Alemka Brnčić-Fischer (committee member)
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za internu medicinu
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-15
Parallel abstract (English)
We hereby investigated the prevalence and the association among long-proton-pump inhibitors (PPIs) use with serum magnesium (Mg) levels in chronic hemodialysis (HD) patients, as well as possible association among PPIs use and increased risk of cardiovascular (CVD) morbidity in HD patients. Additionally, we were interested in exploring if hypomagnesemia in HD patients was associated with the ‘time on PPIs’. Of 418 HD patients that were screened for inclusion, 136 had been excluded due to either incomplete medical data, duration of renal replacement therapy (RRT) for less than 12 months, use of Mg-based phosphate binders or other Mg-based medications or stool softeners, as well as because of the presence of chronic increased gastrointestinal losses. Among 282 patients included in the study, 170 patients were on PPIs. Median time on the PPIs was 26±20 months. There were no significant differences between the two groups in age, duration of RRT, presence of co-morbid conditions, diuretic use, residual renal function, hemoglobin, serum albumins, potassium, sodium, calcium, phosphate and iPTH levels, as well as in Kt/V. Serum Mg levels were significantly lower among PPI users vs. non-users (0.94±0.2 vs. 1.03±0.2 mmol/l p<0.0001). The daily PPIs dose did not show significant correlation to Mg levels (r=0.106; p=0.167), and niether did median duration of PPIs use. Residual renal function did not show significant correlation to Mg concentration (r=-0.102; p=NS) in both groups of patients. However, PPI users had higher rate of adverse CVD events during one year of follow-up, in comparison to non-PPIs users. Noticed difference was not statistically significant (17.6% vs. 10.7%; p=0.110). We have found a significant association between PPIs use and lower serum Mg levels in chronic HD patients.
Parallel keywords (Croatian)inhibitori protonske pumpe serumski magnezij kronična hemodijaliza
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:586311
CommitterBosa Licul