Digestive Health Associates

Southwest Endoscopy Center

PPI Medication Monitoring

This internal practice guideline is intended to be an educational device to provide information that may assist us in providing care to patients. This guideline is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient’s condition and available courses of action. Therefore, clinical considerations may lead a physician to take a course of action that varies from this guideline.
Laboratory tests
General metabolic and hematologic:  CMP, CBC, Mg, iron/TIBC, ferritin, vitamin B12, 25-OH vitamin D, Urine Alb/Cr Ratio, UA

Frequency for Nephrology-specific Monitoring (Serum Cr, Urine Alb/Cr Ratio, UA)
If no known kidney disease
-baseline and Q6-12m for patients with no 
If known kidney disease (including albuminuria)
-Q3m

Frequency for general metabolic and hematologic monitoring
-baseline and Q1-2y


Consider modifying treatment (nephrology perspective) 
-increase of serum Cr >30%
-new albuminuria >30 mg/g
-previously established albuminuria increase >50%
-new presence of active urine sediment (urine WBCs or RBCs)