Are Proton Pump Inhibitors a Risk Factor for Hypomagnesemia in Patients with  Diabetic Kidney Disease

Objective: To compare serum magnesium levels amongst diabetic kidney disease patients using proton pump inhibitors and those not using them. Study Design: Cross-sectional study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi, Pakistan, from May to Jul 2023. Methodology: Patients with diabetic kidney disease stage 3– 5ND were selected, on regular follow-up in outdoor clinic for at least a month. Exclusion criteria included missing information, use of diuretics or magnesium-containing nutritional supplements or multivitamin tablets, and unwillingness. We recorded data on the use of proton pump inhibitors, including their type, dose, and duration of use. Blood sampling was also done for estimation of serum magnesium, urea, creatinine, sodium, potassium, glycosylated hemoglobin levels and albumin: creatinine levels on spot urinary samples. Results: This study was done on 94 patients. The mean age of the participants was 62.48 ± 8.32 years. There were 67(77.5%) males and 27(28.4%) females. Proton pump inhibitors were being used by 58(61.7%) patients, and 36(38.3%) were not used. Conclusion: This study highlights a potential link between hypomagnesemia and proton pump inhibitors in diabetic kidney patients. Care should be exercised by clinicians while dealing with such patients.