Abstract
Este artigo revisa a literatura atual sobre o impacto do uso crônico de inibidores da bomba de prótons (IBPs) na absorção de micronutrientes em pacientes idosos. A seleção dos artigos foi realizada utilizando as bases de dados PubMed, Scopus e Web of Science, com os termos "Proton Pump Inhibitors," "Micronutrient Absorption," "Elderly," e suas correspondentes em português. A revisão abrange estudos recentes que investigam os efeitos dos IBPs na biodisponibilidade de cálcio, ferro, magnésio e vitamina B12, destacando suas implicações clínicas e estratégias para mitigação de riscos. A conclusão aponta que a avaliação individualizada, aliada ao monitoramento regular e à suplementação de micronutrientes, pode minimizar os impactos adversos do uso prolongado de IBPs, contribuindo para uma melhor qualidade de vida em pacientes idosos.
References
BOGHOSSIAN, T. A.; RASHID, F. J.; THOMPSON, W.; et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database of Systematic Reviews, v. 3, n. CD011969, 2017. DOI: 10.1002/14651858.CD011969.pub2.
CHINZON, D.; DOMINGUES, G.; TOSETTO, N.; PERROTTI, M. Safety of long-term proton pump inhibitors: Facts and myths. Arquivos de Gastroenterologia, v. 59, n. 2, p. 219-225, 2022. DOI: 10.1590/S0004-2803.202202000-40.
CHOLIN, L.; ASHOUR, T.; MEHDI, A.; et al. Proton-pump inhibitor vs. H2-receptor blocker use and overall risk of CKD progression. BMC Nephrology, v. 22, n. 1, p. 264, 2021. DOI: 10.1186/s12882-021-02449-0.
CORLETTI, P. G.; STACCHINI, A.; LANZARIN, G.; CAVALLARO, L. G.; PILOTTO, A.; FRANCESCHI, M.; DI MARIO, F. Effect of omeprazole on iron absorption in patients with functional dyspepsia. Digestive Diseases and Sciences, v. 46, n. 3, p. 518-521, 2001. DOI: 10.1023/a:1005641712971.
DEN ELZEN, W. P. J.; GROENEVELD, Y.; DE RUIJTER, W.; VERBEEK, A. L. M.; WEEL, A. E. B.; GUSSEKLOO, J. Long-term use of proton pump inhibitors and vitamin B12 status in elderly individuals.Alimentary Pharmacology & Therapeutics, v. 32, n. 9, p. 910-916, 2010. DOI: 10.1111/j.1365-2036.2010.04419.x.
DESBUISSONS, G.; DERAY, G.; MERCADAL, L. Proton pump inhibitors and kidney. Nephrologie & Therapeutique, v. 14, Suppl. 1, p. S115-S124, 2018. DOI: 10.1016/j.nephro.2017.06.005.
EL CHAMIEH, C.; LARABI, I. A.; LAVILLE, S. M.; JACQUELINET, C.; COMBE, C.; FOUQUE, D.; LAVILLE, M.; FRIMAT, L.; PECOITS-FILHO, R.; ALENCAR DE PINHO, N. Proton-pump inhibitors and serum concentrations of uremic toxins in patients with chronic kidney disease. Toxins (Basel), v. 15, n. 4, p. 276, 2023. DOI: 10.3390/toxins15040276.
FITZPATRICK, D.; LANNON, R.; LAIRD, E.; WARD, M.; HOEY, L.; HUGHES, C. F.; et al. The association between proton pump inhibitors and hyperparathyroidism: A potential mechanism for increased fractures.Osteoporosis International, v. 34, n. 11, p. 1917-1926, 2023. DOI: 10.1007/s00198-023-06867-8.
GILARDI, D.; FALASCA, K.; NUNZIATA, M.; ZACCAGNINI, M.; DI PIETRO, R.; et al. Proton pump inhibitors and risk of hypomagnesemia: a case-control study in a primary care setting. European Journal of Internal Medicine, v. 26, n. 9, p. 696, 2015. DOI: 10.1016/j.ejim.2015.07.022.
HART, E.; DUNN, T. E.; FEUERSTEIN, S.; JACOBS, D. M. Proton pump inhibitors and risk of acute and chronic kidney disease: A retrospective cohort study. Pharmacotherapy, v. 39, n. 4, p. 443-453, 2019. DOI: 10.1002/phar.2235.
ITO, T.; RAMOS-ALVAREZ, I.; JENSEN, R. T. Long-term proton pump inhibitor-acid suppressive treatment can cause vitamin B12 deficiency in Zollinger-Ellison syndrome (ZES) patients. International Journal of Molecular Sciences, v. 25, n. 13, p. 7286, 2024. DOI: 10.3390/ijms25137286.
KHALILI, H.; HUANG, E. S.; JACOBSEN, S.; CAMARGO JR., C. A.; FESKANICH, D.; CHAN, A. T. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. BMJ, v. 344, p. e372, 2012. DOI: 10.1136/bmj.e372.
KOYYADA, A. Long-term use of proton pump inhibitors as a risk factor for various adverse manifestations.Therapie, v. 76, n. 1, p. 13-21, 2021. DOI: 10.1016/j.therap.2020.06.019.
LAM, J. R.; SCHULTZ, M.; CRUZ, S.; CORLEY, D. A. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA, v. 310, n. 22, p. 2435-2442, 2013. DOI: 10.1001/jama.2013.280490.
MCCOLL, K. E. L.; EL-OMAR, E. M.; HOWDEN, C. W. Interactions between proton pump inhibitors and micronutrient absorption: Implications for clinical practice. Alimentary Pharmacology & Therapeutics, v. 44, n. 9, p. 920-930, 2016. DOI: 10.1111/apt.13812.
MERLI, M.; LUCIDI, C.; GREGORIO, V. D.; et al. Chronic use of proton pump inhibitors, adverse events, and potential biological mechanisms. Liver International, v. 35, n. 2, p. 362-369, 2015. DOI: 10.1111/liv.12593.
MIKOLASEVIC, I.; MILIC, S.; STIMAC, D.; ORLIC, L. Is there a relationship between hypomagnesemia and proton pump inhibitors in patients on chronic hemodialysis? European Journal of Internal Medicine, v. 30, p. 99-103, 2016. DOI: 10.1016/j.ejim.2016.01.026.
MOAYYEDI, P.; EIKELEBOOM, J. W.; BOSCH, J.; et al. Safety of proton pump inhibitors based on a large, multi-year randomized trial. Gastroenterology, v. 157, n. 3, p. 682-691.e2, 2019. DOI: 10.1053/j.gastro.2019.05.056.
ORTIZ-GUERRERO, G.; AMADOR-MUÑOZ, D.; CALDERÓN-OSPINA, C. A.; et al. Proton pump inhibitors and dementia: Physiopathological mechanisms and clinical consequences. Neural Plasticity, v. 2018, p. 5257285, 2018. DOI: 10.1155/2018/5257285.
TRAN-DUY, A.; CONNELL, N. J.; VANMOLKOT, F. H.; et al. Use of proton pump inhibitors and risk of iron deficiency: a population-based case-control study. Journal of Internal Medicine, v. 285, n. 2, p. 205-214, 2019. DOI: 10.1111/joim.12826.
YANG, H.; JUANG, S. Y.; LIAO, K. F. Proton pump inhibitors use and risk of chronic kidney disease in diabetic patients. Diabetes Research and Clinical Practice, v. 147, p. 67-75, 2019. DOI: 10.1016/j.diabres.2018.11.019.
YANG, Y. X.; LEWIS, J. D.; EPSTEIN, S.; METZ, D. C. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA, v. 296, n. 24, p. 2947-2953, 2006. DOI: 10.1001/jama.296.24.2947.
ZHANG, Y.; ZHOU, L.; ZHANG, J.; LI, Y.; ZHAO, Y. Proton pump inhibitors and risk of vitamin and mineral deficiencies in the elderly: A systematic review and meta-analysis. Journal of the American Geriatrics Society, v. 67, n. 5, p. 1197-1205, 2019. DOI: 10.1111/jgs.15897.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Thiago Henrique de Andrade Barbosa, Raphael Henrique Gomes de Melo, Juliano Infantino Maciel