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Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients
Proton-pump inhibitor (PPI) use may influence intestinal iron absorption. Low iron status and iron deficiency (ID) are frequent medical problems in renal transplant recipients (RTR). We hypothesized that chronic PPI use is associated with lower iron status and ID in RTR. Serum iron, ferritin, transf...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780301/ https://www.ncbi.nlm.nih.gov/pubmed/31484461 http://dx.doi.org/10.3390/jcm8091382 |
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author | Douwes, Rianne M. Gomes-Neto, António W. Eisenga, Michele F. Vinke, Joanna Sophia J. de Borst, Martin H. van den Berg, Else Berger, Stefan P. Touw, Daan J. Hak, Eelko Blokzijl, Hans Navis, Gerjan Bakker, Stephan J.L. |
author_facet | Douwes, Rianne M. Gomes-Neto, António W. Eisenga, Michele F. Vinke, Joanna Sophia J. de Borst, Martin H. van den Berg, Else Berger, Stefan P. Touw, Daan J. Hak, Eelko Blokzijl, Hans Navis, Gerjan Bakker, Stephan J.L. |
author_sort | Douwes, Rianne M. |
collection | PubMed |
description | Proton-pump inhibitor (PPI) use may influence intestinal iron absorption. Low iron status and iron deficiency (ID) are frequent medical problems in renal transplant recipients (RTR). We hypothesized that chronic PPI use is associated with lower iron status and ID in RTR. Serum iron, ferritin, transferrin saturation (TSAT), and hemoglobin were measured in 646 stable outpatient RTR with a functioning allograft for ≥ 1 year from the “TransplantLines Food and Nutrition Biobank and Cohort Study” (NCT02811835). Median time since transplantation was 5.3 (1.8–12.0) years, mean age was 53 ± 13 years, and 56.2% used PPI. In multivariable linear regression analyses, PPI use was inversely associated with serum iron (β = −1.61, p = 0.001), natural log transformed serum ferritin (β = −0.31, p < 0.001), TSAT (β = −2.85, p = 0.001), and hemoglobin levels (β = −0.35, p = 0.007), independent of potential confounders. Moreover, PPI use was independently associated with increased risk of ID (Odds Ratio (OR): 1.57; 95% Confidence Interval (CI) 1.07–2.31, p = 0.02). Additionally, the odds ratio in RTR taking a high PPI dose as compared to RTR taking no PPIs (OR 2.30; 95% CI 1.46–3.62, p < 0.001) was higher than in RTR taking a low PPI dose (OR:1.78; 95% CI 1.21–2.62, p = 0.004). We demonstrated that PPI use is associated with lower iron status and ID, suggesting impaired intestinal absorption of iron. Moreover, we found a stronger association with ID in RTR taking high PPI dosages. Use of PPIs should, therefore, be considered as a modifiable cause of ID in RTR. |
format | Online Article Text |
id | pubmed-6780301 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-67803012019-10-30 Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients Douwes, Rianne M. Gomes-Neto, António W. Eisenga, Michele F. Vinke, Joanna Sophia J. de Borst, Martin H. van den Berg, Else Berger, Stefan P. Touw, Daan J. Hak, Eelko Blokzijl, Hans Navis, Gerjan Bakker, Stephan J.L. J Clin Med Article Proton-pump inhibitor (PPI) use may influence intestinal iron absorption. Low iron status and iron deficiency (ID) are frequent medical problems in renal transplant recipients (RTR). We hypothesized that chronic PPI use is associated with lower iron status and ID in RTR. Serum iron, ferritin, transferrin saturation (TSAT), and hemoglobin were measured in 646 stable outpatient RTR with a functioning allograft for ≥ 1 year from the “TransplantLines Food and Nutrition Biobank and Cohort Study” (NCT02811835). Median time since transplantation was 5.3 (1.8–12.0) years, mean age was 53 ± 13 years, and 56.2% used PPI. In multivariable linear regression analyses, PPI use was inversely associated with serum iron (β = −1.61, p = 0.001), natural log transformed serum ferritin (β = −0.31, p < 0.001), TSAT (β = −2.85, p = 0.001), and hemoglobin levels (β = −0.35, p = 0.007), independent of potential confounders. Moreover, PPI use was independently associated with increased risk of ID (Odds Ratio (OR): 1.57; 95% Confidence Interval (CI) 1.07–2.31, p = 0.02). Additionally, the odds ratio in RTR taking a high PPI dose as compared to RTR taking no PPIs (OR 2.30; 95% CI 1.46–3.62, p < 0.001) was higher than in RTR taking a low PPI dose (OR:1.78; 95% CI 1.21–2.62, p = 0.004). We demonstrated that PPI use is associated with lower iron status and ID, suggesting impaired intestinal absorption of iron. Moreover, we found a stronger association with ID in RTR taking high PPI dosages. Use of PPIs should, therefore, be considered as a modifiable cause of ID in RTR. MDPI 2019-09-03 /pmc/articles/PMC6780301/ /pubmed/31484461 http://dx.doi.org/10.3390/jcm8091382 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Douwes, Rianne M. Gomes-Neto, António W. Eisenga, Michele F. Vinke, Joanna Sophia J. de Borst, Martin H. van den Berg, Else Berger, Stefan P. Touw, Daan J. Hak, Eelko Blokzijl, Hans Navis, Gerjan Bakker, Stephan J.L. Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients |
title | Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients |
title_full | Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients |
title_fullStr | Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients |
title_full_unstemmed | Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients |
title_short | Chronic Use of Proton-Pump Inhibitors and Iron Status in Renal Transplant Recipients |
title_sort | chronic use of proton-pump inhibitors and iron status in renal transplant recipients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780301/ https://www.ncbi.nlm.nih.gov/pubmed/31484461 http://dx.doi.org/10.3390/jcm8091382 |
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