The effect of proton-pump inhibitor and ranitidine on the reduction of serum magnesium level and blood pressure in chronic hemodialysis patients with hypotension; a doubleblind clinical trial

Introduction: Hypomagnesaemia secondary to the use of proton-pump inhibitor (PPI) is associated with the reduction of blood pressure. Objectives: To determine the effect of PPI and ranitidine on the reduction of serum magnesium level and blood pressure in chronic hemodialysis patients with hypotension. Patients and Methods: In this double-blind randomized clinical trial, 44 hemodialysis patients who met the requirements entered the study. First, blood sample was taken from each of the patients and their serum magnesium level as well as their blood pressure was checked and recorded. Then, the patients in the intervention group received daily doses of ranitidine placebo (150 mg) and pantoprazole (40 mg) and those in the control group received daily doses of pantoprazole placebo (40 mg) and ranitidine (150 mg) for three months. After the intervention, blood samples were taken again in order to assess the patients’ serum magnesium level. The obtained data were fed into SPSS Software and analyzed. Results: The mean age of the patients was 60.14±12.98 years. Moreover, 63.6% of the total patients were female. In the group of patients who had received pantoprazole, diastolic pressure reduced significantly at the end of the study as compared to the beginning of the study. Moreover, in the patients receiving pantoprazole indicated a significant reduction of magnesium at the end of the study as compared to the beginning of the study. Conclusion: In this study, a significant relationship was also observed between the use of PPI and hypomagnesemia in hemodialysis patients. Trial registration: The trial protocol was approved in the Iranian Registry of Clinical Trials (identifier: IRCT20150808023559N19; https://en.irct.ir/trial/42478, ethical code# IR.ARUMS. REC.1398.295).