Response Letter to Walker and Colleagues

Abstract

To the Editor: We appreciate the comments from Walker et al. and acknowledge the importance of proton pump inhibitor (PPI) use and magnesium balance in individuals with chronic kidney disease (CKD).1 Our focus was to evaluate whether age modified the association between glomerular filtration rate (GFR) and metabolic complications; we chose anemia, hyperphosphatemia, acidosis, and hyperkalemia because they are all components of the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines.2-5 Therefore, although not directly relevant to the research question in the current letter, further study of the association between CKD, PPI use, and magnesium balance is an important area for future research. A recent letter from Sumukadas et al. reported on the association between CKD, PPI use, and magnesium levels in hospitalized individuals.6 PPI use was associated with lower magnesium levels in individuals with CKD but did not affect magnesium levels in those with normal renal function. In individuals not taking a PPI, magnesium levels appeared to be higher in individuals with CKD than in those with normal renal function, but this relationship was not formally tested; in individuals taking a PPI, magnesium levels did not differ according to CKD status.6 This study was small and only included hospitalized individuals; as Walker et al. state, further research is necessary to understand the relationship between CKD and magnesium levels. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. The project described was supported in part by Award K23DK087919 (PED) from the National Institute of Diabetes and Digestive and Kidney Diseases. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health. Author Contributions: Drawz and Rahman are responsible for drafting and editing the letter and take full responsibility for its content. Sponsor's Role: Not applicable.