TY - JOUR
T1 - Uses of proton pump inhibitors and serum potassium levels
AU - Gau, Jen Tzer
AU - Heh, Victor
AU - Acharya, Utkarsh
AU - Yang, Yu Xiao
AU - Kao, Tzu Cheg
PY - 2009
Y1 - 2009
N2 - Purpose: Proton pump inhibitor (PPI) may suppress adrenal cortical steroid synthesis and release, thereby leading to electrolyte disturbances. Both hyponatremia and hyperkalemia in the setting of PPI therapy have been documented in case reports. The objective of this study was to examine the association between serum potassium (K+) level and PPI use. Methods A retrospective data analysis of hospitalized adults aged ≥65 years during 2006, including PPI users (N=257) and PPI non-users (N=388), was conducted. Multiple linear and logistic regression analyses were used to assess the association between PPI use and serum K+ level. Results PPI users [mean age (SD):79.7 (8.0) years; 70% female] had significantly higher serum K+ levels than PPI non-users [80.2 (8.8) years; 64% female] on admission [4.13 (0.62) vs. 3.97 (0.57) mmol/L; p<0.001]. The linear regression model revealed that ≥2 defined daily dose (DDD) units of PPI use were a significantly positive contributor to serum K+ levels ( p=0.021) after adjusting for age, serum creatinine levels, sex, history of diabetes, and uses of the following drugs: angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker, b blocker, diuretics, spironolactone, K+ supplement, non-steroidal anti-inflammatory drugs, atypical antipsychotics, and narcotics. However, multiple logistic regression model revealed that high dose PPI therapy was not associated with an increased risk for hyperkalemia occurrence (p=0.762). Conclusion Higher serum K+ levels were observed among PPI users when compared to PPI non-users. High daily dose PPI therapy may be an independent positive predictor of serum potassium levels.
AB - Purpose: Proton pump inhibitor (PPI) may suppress adrenal cortical steroid synthesis and release, thereby leading to electrolyte disturbances. Both hyponatremia and hyperkalemia in the setting of PPI therapy have been documented in case reports. The objective of this study was to examine the association between serum potassium (K+) level and PPI use. Methods A retrospective data analysis of hospitalized adults aged ≥65 years during 2006, including PPI users (N=257) and PPI non-users (N=388), was conducted. Multiple linear and logistic regression analyses were used to assess the association between PPI use and serum K+ level. Results PPI users [mean age (SD):79.7 (8.0) years; 70% female] had significantly higher serum K+ levels than PPI non-users [80.2 (8.8) years; 64% female] on admission [4.13 (0.62) vs. 3.97 (0.57) mmol/L; p<0.001]. The linear regression model revealed that ≥2 defined daily dose (DDD) units of PPI use were a significantly positive contributor to serum K+ levels ( p=0.021) after adjusting for age, serum creatinine levels, sex, history of diabetes, and uses of the following drugs: angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor blocker, b blocker, diuretics, spironolactone, K+ supplement, non-steroidal anti-inflammatory drugs, atypical antipsychotics, and narcotics. However, multiple logistic regression model revealed that high dose PPI therapy was not associated with an increased risk for hyperkalemia occurrence (p=0.762). Conclusion Higher serum K+ levels were observed among PPI users when compared to PPI non-users. High daily dose PPI therapy may be an independent positive predictor of serum potassium levels.
KW - Hospitalized older adults
KW - Hyperkalemia
KW - Proton pump inhibitors
KW - Serum potassium level
UR - http://www.scopus.com/inward/record.url?scp=70450190145&partnerID=8YFLogxK
U2 - 10.1002/pds.1795
DO - 10.1002/pds.1795
M3 - Article
C2 - 19557730
AN - SCOPUS:70450190145
SN - 1053-8569
VL - 18
SP - 865
EP - 871
JO - Pharmacoepidemiology and Drug Safety
JF - Pharmacoepidemiology and Drug Safety
IS - 9
ER -