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Pubblicato il 9 dicembre 2016

Review: UPDATE sul metabolismo del magnesio

Inibitori di pompa protonica, magnesio e IRC

Proton pump inhibitors, magnesium and CKD

Review: UPDATE sul metabolismo del magnesio

Review: UPDATE on magnesium metabolism

Pasquale Fatuzzo1, Luca Zanoli1, Viviana Scollo1, Grazia Portale1, Agostino Gaudio1, Alessandra Pani1, Antonio Granata2

(1) Dipartimento di Medicina Interna, Scuola di Specializzazione in Nefrologia, Università di Catania, A.O.U. “Policlinico-Vittorio Emanuele”, Catania, Italia.
(2) UOC Nefrologia e Dialisi, P.O. “San Giovanni di Dio”, Agrigento, Italia.

Corrispondenza a: Pasquale Fatuzzo; Dipartimento di Medicina Interna, Scuola di Specializzazione in Nefrologia, Università di Catania, AOU “Policlinico-Vittorio Emanuele”, Via Santa Sofia 78, 95123, Catania, Italia; Tel: +39 095 37 81 530; Fax: +39 095 37 82 376; E-mail: fatuzzo@unict.it

Abstract

Il magnesio rappresenta il secondo catione più presente nell’ambiente intracellulare e il quarto minerale più abbondante nell’intero organismo. Una sua carenza è stata associata a numerose patologie, tra cui insulino-resistenza e diabete, asma, osteoporosi ed insufficienza renale cronica (IRC). Gli inibitori di pompa protonica rappresentano una delle principali cause di ipomagnesemia. Il rischio di ipomagnesemia e del conseguente peggioramento della funzione renale aumenta in seguito all’uso concomitante di diuretici ed inibitori di pompa protonica, due classi di farmaci comunemente usate nei pazienti con IRC. In questa review abbiamo passato in rassegna i principali meccanismi alla base della comparsa di ipomagnesemia e le conseguenze di questa disionia nei pazienti con IRC.

Abstract

Magnesium is the second intracellular cation and the fourth most abundant mineral in the body. Low levels of magnesium have been associated with insulin resistance and type-2 diabetes mellitus, asthma, osteoporosis and chronic kidney disease (CKD). The use of proton pump inhibitors (PPIs) represents the most common cause of hypomagnesemia. The risk of hypomagnesemia, and consequently worsening of the renal function, is increased when diuretics are added to therapy in subjects treated with PPIs. Interestingly, diuretics and PPIs are two of the most used drugs in subjects with CKD. In this review, we described the mechanisms at the basis of the hypomagnesemia and the effect of this electrolyte disturbance in subjects with CKD.

Tabella 1. Effetto dei farmaci sull’assorbimento ed eliminazione del magnesio
Farmaci che riducono l’assorbimento di magnesioFarmaci che aumentano l’eliminazione di magnesio
Tetracicline Cisplatino
Inibitori di pompa protonica Furosemide
Inibitori delle calcineurine Tiazidici
Salazopirina Gentamicina
Inibitore del EGFR  
×

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Contenuti articolo
    release  1
    pubblicata il  09 dicembre 2016 
    Da

    Pasquale Fatuzzo1, Luca Zanoli1, Viviana Scollo1, Grazia Portale1, Agostino Gaudio1, Alessandra Pani1, Antonio Granata2

    (1) Dipartimento di Medicina Interna, Scuola di Specializzazione in Nefrologia, Università di Catania, A.O.U. “Policlinico-Vittorio Emanuele”, Catania, Italia.
    (2) UOC Nefrologia e Dialisi, P.O. “San Giovanni di Dio”, Agrigento, Italia.

    Corrispondenza a: Pasquale Fatuzzo; Dipartimento di Medicina Interna, Scuola di Specializzazione in Nefrologia, Università di Catania, AOU “Policlinico-Vittorio Emanuele”, Via Santa Sofia 78, 95123, Catania, Italia; Tel: +39 095 37 81 530; Fax: +39 095 37 82 376; E-mail: fatuzzo@unict.it

    Parole chiave: diuretici, inibitori di pompa protonica, insufficienza renale cronica, magnesio
    Key words: chronic kidney disease, diuretics, magnesium, proton pump inhibitors
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