The effect of the use of proton pump inhibitors withphosphor binding agents on phosphorus level inhemodialysis patients

Background and Aims An increase in serum phosphorus is an independent risk factor for mortality in patients with chronic renal failure or undergoing dialysis due to end-stage renal failure. Phosphorus binding agents are aim the reduce phosporus level drugs, used in chronic kidney failure patients. Proton pump inhibitors are also the general name given to agents used to suppress stomach acid. In this study, we aimed to investigate how phosphorus control is used in patients who use a proton pump inhibitor together with a phosphorus binding agent and whether its concomitant use brings additional benefits. We will also investigate whether there is a relationship between the phosphorus binding agent used. Materials and Method We aimed to investigate phosphorus control between 392 end-stage renal failure patients who use a phosphorus binding agent without taking a proton pump inhibitor and who take the phosphorus binding agent together with a proton pump inhibitor. We will also investigate whether there is a relationship between this condition and the phosphorus binding agent used. For this, patient follow-up, anamnesis, laboratory and treatment forms in the centers where patients undergo hemodialysis will be used. The information in this form will be collected, and the laboratory and demographic data of patients who have been receiving hemodialysis treatment for at least 6 months and who have been taking phosphorus-binding medication for 3 months will be recorded in the SPSS 21 program and it will be investigated whether the use of a proton pump inhibitor and the use of phosphorus binder adds additional benefits to phosphorus control. Results The study population is 392 patients and they was grouped according to the phosphorus binding agent used and the use of PPI. Mean phosphorus level of patients using PPI (n: ix 238) was 5.03 ± 1.2 mg / dl and without using PPİ(n:154) 5.18 ± 1.19 mg / dl (p: 0.35).When the patients separate the individual phosphorus binding agents, the mean phosphorus level of patients who use PPI with calcium carbonate (n: 24) is 5 ± 1.36 mg / dl without use PPI (n: 4) is 4.47 ± 1.36 mg / dl (p: 0.322). Average phosphorus level of patients using PPI with calcium acetate (n: 79) 5.17 ± 1.07 mg / dl, without PPI (n: 24) 5.62 ± 1.23 mg / dl (p: 0.072). The patients who using another phosphor binding agent as sevalemer with PPİ(n:12) mean phosphorus levels of 6,01±2,39 mg/dl without PPİ (n: 8) mean phosphorus level of 6.31 ± 0.42. The mean phosphorus level of patients who used PPI together with Sinekalset (n: 16) was 5.67 ± 1.19 mg / dl, and the average phosphorus level of patients who used synecalset without PPI was 5.99 ± 1.08 mg / dl (p:0.481). The mean phosphorus level of patients who used PPI together with lanthanum (n: 7) was 5.24 ± 1.49 mg / dl without using PPİ when using lantanyum(n:3) mean phosporus level was founded 5.4 ± 1.1 mg / dl. Conclusion Although there was no statistical significance in patients using PPI independent of the phosphorus binder (p: 0.355), the mean phosphorus level was found to be 0.15 mg / dl lower than those who did not using PPI. When seperatly looking at the agents one by one, the average phosphorus level of patients who used PPI together with lanthanum was found to be lower than those who did not use 0,06 mg / dl PPI, and this result was statistically significant. Except for those who use calcium carbonate in other phosphor binders, the patients who use phosphorus binders together with PPI have been found to have lower average phosphorus levels but no statistically significant results have been found.