Magnesium deficiency tied to mortality risk in renal disease

  • Xiong J & al.
  • J Nephrol
  • 19 Mar 2019

  • International Clinical Digest
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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%).

Limitations

  • High heterogeneity.
  • Variations in magnesium categories.
  • Single magnesium measurement.
  • Limited data for CKD, peritoneal dialysis.
  • Slight publication bias.