Association Between Proton Pump Inhibitor Use and Anemia: A Retrospective Cohort Study

Sarzynski, Erin M.; Puttarajappa, Chethan; Xie, Yan; Grover, Madhusudan; Laird-Fick, Heather

doi:10.1007/s10620-011-1589-y

Cited by 108 publications

(87 citation statements)

References 18 publications

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“…High levels of consumption of coffee and tea and the excessive use of medications to inhibit stomach acid secretion may interfere with iron absorption. 19,20 While studies examining IDA in military personnel are limited, these findings are consistent with a recent study of iron status, ID and IDA prevalence among military personnel deployed to Afghanistan that found ID in 1 percent and 6 percent and IDA in 0 percent and 2 percent of males and females, respectively. 11 This report shows that 18 percent of females and 10 percent of males diagnosed with IDA experience a recurrence (i.e., recurrent or chronic) of their condition.…”

Section: E D I T O R I a L C O M M E N Tsupporting

confidence: 84%

Medical Surveillance Monthly Report. Volume 19, Number 7

O'Donnell¹,

Brundage²,

Wertheimer³

et al. 2012

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Section: E D I T O R I a L C O M M E N Tsupporting

confidence: 84%

Medical Surveillance Monthly Report. Volume 19, Number 7

O'Donnell¹,

Brundage²,

Wertheimer³

et al. 2012

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“…One report describes that PPI use increased the length of intervals between bloodletting in patients with hemochromatosis (10). Sarzynski et al also retrospectively studied 98 patients who had started using PPIs and found that the hemoglobin (Hb) level had decreased in many of the patients one year later (11). A subgroup analysis was performed in that study, and possible correlations were examined between a decreased Hb level and various patient attributes, such as Helicobacter pylori infection, oral antiplatelet drug use and past medical history; however, no items correlating with a decreased Hb level were found.…”

Section: Discussionmentioning

confidence: 99%

Iron-deficiency Anemia Caused by a Proton Pump Inhibitor

Hashimoto¹,

Matsuda²,

Chonan³

2014

Intern. Med.

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A 59-year-old man was orally administered rabeprazole, a proton pump inhibitor (PPI), for gastroesophageal reflux disease, after which he gradually developed iron-deficiency anemia. The anemia did not improve following the administration of ferrous fumarate, and endoscopic screening of the entire gastrointestinal tract, including the small intestine, did not reveal any findings indicating the cause of the anemia. The patient was then switched from rabeprazole to famotidine and the anemia was cured within three months. There is much debate as to whether the long-term use of PPIs causes iron-deficiency. However, this case strongly suggests that PPIs can induce iron-deficiency anemia.

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“…Long-lasting PPI treatment is considered to increase risk for hip, wrist, and spine fractures, although there are no unanimously agreed pathophysiological mechanisms [8]. Treatment-induced acid suppression is connected with decreased absorption of iron and vitamin B, with consequent occurrence of anaemia [9,10]. Meta-analyses on a large scale population reported on escalation of community-acquired pneumonia in a population treated with PPI [11].…”

Section: Introductionmentioning

confidence: 99%

Connections between nutritional status and proton pump inhibitor therapy in patients scheduled for cardiovascular rehabilitation after treatment for ischaemic and valvular heart disease

et al. 2016

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A b s t r a c t Background:Multiple and yet uncertain connections exist between cardiovascular diseases and the nutritional status of patients, particularly in relation to cardiovascular treatments. Proton pump inhibitors (PPI) are among the most commonly used group of drugs. Aim:To analyse utilisation of PPI in association with nutritional risk of patients scheduled for rehabilitation after treatment for ischaemic and valvular heart disease. Methods:Retrospective analyses on a consecutive sample of patients, which included drug utilisation of PPI and nutritional risk screening, using a standardised NRS-2002 tool. The patients (n = 536) were divided into groups based on previous cardiovascular treatments and use of PPI.Results: Nearly half of the patients (244, 46.1%) had PPI in their chronic therapy despite the clinically negligible prevalence of conditions that are their fundamental indications. The odds for using PPI in patients with increased nutritional risk, estimated by logistic regression, were 3.34 (95% confidence intervals [CI] 2.26-4.94), p < 0.001. Receiver operating curve analyses also revealed significant differences of PPI utilisation in connection with NRS-2002 > 3: positive likelihood-ratio (LR) 2.35 (95% CI 2.10-2.60); negative LR 0.46 (95% CI 0.4-0.6); area under the curve (AUC) 0.720; p < 0.001; as well as the percentage weigh loss history > 6.36% (positive LR 2.22 [95% CI 2.00-2.50]; negative LR 0.41 [95% CI 0.30-0.50]; AUC 0.707; p < 0.001).Conclusions: Utilisation of PPI was found to be of relatively high prevalence and significantly associated with parameters of nutritional risk screening. Furthermore, it was in correlation with the age of patients and the existence of chronic kidney disease, which are well-established predispositions for poor nutritional status. Nutritional risk seems to be additionally negatively challenged by utilisation of PPI due to gastric malabsorption and anaemia.

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Association Between Proton Pump Inhibitor Use and Anemia: A Retrospective Cohort Study

Abstract: Among adult patients receiving chronic PPI therapy, there is a significant decrease in hematologic indices from baseline.

Cited by 108 publications

References 18 publications

Medical Surveillance Monthly Report. Volume 19, Number 7

Medical Surveillance Monthly Report. Volume 19, Number 7

Iron-deficiency Anemia Caused by a Proton Pump Inhibitor

Connections between nutritional status and proton pump inhibitor therapy in patients scheduled for cardiovascular rehabilitation after treatment for ischaemic and valvular heart disease

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