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Letter regarding the article “The impact of hypomagnesemia on erectile dysfunction in elderly, non-diabetic, stage 3 and 4 chronic kidney disease patients: a prospective cross-sectional study”

Authors Fatuzzo P, Zanoli L, Scollo V

Received 18 March 2017

Accepted for publication 21 March 2017

Published 28 April 2017 Volume 2017:12 Pages 741—743

DOI https://doi.org/10.2147/CIA.S137411

Checked for plagiarism Yes

Editor who approved publication: Dr Richard Walker


Pasquale Fatuzzo,* Luca Zanoli,* Viviana Scollo

Department of Clinical and Experimental Medicine, Section of Nephrology, University of Catania, Catania, Italy

*These authors contributed equally to this work
 
In an article published in a recent issue of Clinical Interventions in Aging, Toprak et al1 found that, among patients with stage 3–4 chronic kidney disease (CKD), the prevalence of erectile dysfunction was higher in patients with hypomagnesemia. This finding is clinically relevant because it supports the hypothesis that hypomagnesemia may lead to inflammation2 and endothelial dysfunction, two causes of erectile dysfunction. Toprak et al1 concluded that the detection of the serum magnesium level in non-diabetic elderly men with CKD could be useful to assess the risk of erectile dysfunction. Consequently, it is important to assess the causes of hypomagnesemia in patients with CKD, in particular the causes that are potentially reversible. With this in mind, hypomagnesemia could be caused by the long-term use of proton pump inhibitors,2,3 widely used in patients with CKD but not reported in the study of Toprak et al,1 alone or in combination with diuretics2 or cyclosporine.4

Authors’ reply

Omer Toprak,1 Yasin Sarı,2 Akif Koç,3 Erhan Sarı,3 Ali Kırık2

1
Division of Nephrology, 2Division of Internal Medicine, 3Division of Urology, Department of Medicine, Balikesir University School of Medicine, Balikesir, Turkey 

We are in full agreement with Fatuzzo et al that it is important to assess the causes of hypomagnesemia in patients with chronic kidney disease.1,2 Hypomagnesemia may be caused by malabsorption, inflammatory bowel disease or gastrointestinal disorders, diarrheal diseases, alcohol abuse, use of laxatives, diuretics, corticosteroids, oral contraceptives, bile acid sequestrants, proton pump inhibitors, amphotericin B, aminoglycosides, tetracycline, chemotherapy drugs (cisplatin, amsacrine), immunosuppressants (cyclosporine, sirolimus), bisphosphonates, beta adrenergic agonists, foscarnet, pentamidine, hypokalemia, hypocalcemia, inherited renal tubular defects, and kidney transplantation.2

View the original paper by Toprak and colleagues
 

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