- A large meta-analysis ties magnesium deficiency to increased risks for cardiovascular and all-cause mortality in patients with chronic kidney disease (CKD) and end-stage renal disease.
Why this matters
- Serum magnesium warrants monitoring in patients with CKD and those on dialysis.
- Further studies are needed to elucidate potential benefits of magnesium correction.
- Systematic review, meta-analysis of 20 prospective and retrospective cohort studies involving 200,934 patients from the United States, Asia, and Europe.
- Studies involved patients with CKD (4) and those undergoing hemodialysis (13), peritoneal dialysis (5), or both (2).
- Funding: None disclosed.
- In multivariate analysis, hypomagnesemia was associated with 32% higher risk for all-cause mortality vs normal magnesium or hypermagnesemia (HR, 1.32; P<.00001 i>2=55%).
- In contrast, hypermagnesemia was linked to decreased risk for all-cause mortality (per unit increase: HR, 0.86; P=.001; I2=84%).
- Effect appeared driven by 29% lower risk for cardiovascular mortality (HR, 0.71; P=.003; I2=75%).
- Among hemodialysis-dependent patients:
- Hypomagnesemia was tied to 29% higher risk for all-cause mortality (HR, 1.29; P=.0005; I2=65%).
- Hypermagnesemia was tied to 27% decreased risk for all-cause mortality (HR, 0.73; P=.008; I2=80%).
- High heterogeneity.
- Variations in magnesium categories.
- Single magnesium measurement.
- Limited data for CKD, peritoneal dialysis.
- Slight publication bias.