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Lower serum magnesium is associated with cardiovascular risk factors and mortality in haemodialysis patients
Patrícia João Matias1, Ana Azevedo, Ivo Laranjinha
1Nephrocare - Vila Franca de Xira - Dialysis Unit, Vila Franca de Xira, Portugal.
Insights
Low magnesium levels in hemodialysis patients are linked to higher cardiovascular risk markers like pulse pressure and vascular calcifications. This association also predicts increased mortality in these patients.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biochemistry
Background:
- Hypomagnesaemia (low magnesium) is a known cardiovascular risk factor in the general population.
- Hemodialysis patients represent a unique population where magnesium levels may significantly impact health outcomes.
Purpose of the Study:
- To investigate the association between pre-dialysis serum magnesium levels and cardiovascular risk markers in hemodialysis patients.
- To determine if magnesium levels predict mortality in this patient group.
Main Methods:
- A 48-month prospective study involving 206 hemodialysis patients.
- Patients received pre-dilution hemodiafiltration with a dialysate magnesium concentration of 1 mmol/l.
Main Results:
- Lower magnesium concentrations correlated with increased pulse pressure, left ventricular mass index, and vascular calcifications.
- Patients with magnesium levels below 1.15 mmol/l exhibited lower survival rates.
- Serum magnesium below 1.15 mmol/l independently predicted all-cause and cardiovascular mortality, even after adjusting for other risk factors.
Conclusions:
- Reduced magnesium levels in hemodialysis patients are associated with elevated cardiovascular risk markers.
- Low magnesium is a significant predictor of increased mortality in patients undergoing hemodialysis.
Background:
Hypomagnesaemia is a cardiovascular (CV) risk factor in the general population. The aim of this study was to evaluate the relationship between pre-dialysis magnesium (Mg) and CV risk markers, [including pulse pressure (PP), left ventricular mass index (LVMI) and vascular calcifications (VC)], and mortality in haemodialysis (HD) patients.
Methods:
We performed a 48-month prospective study in 206 patients under pre-dilution haemodiafiltration with a dialysate Mg concentration of 1 mmol/l.
Results:
Lower Mg concentrations were predictors of an increased PP (≥65 mm Hg) (p = 0.002) and LVMI (≥140 g/m(2)) (p = 0.03) and of a higher VC score (≥3) (p = 0.01). Patients with Mg <1.15 mmol/l had a lower survival at the end of the study (p = 0.01). Serum Mg <1.15 mmol/l was an independent predictor of all-cause (p = 0.01) and CV mortality (p = 0.02) when adjusted for multiple CV risk factors.
Conclusions:
Lower Mg levels seem to be associated with increased CV risk markers, like PP, LVMI and VC, and with higher mortality in HD patients.
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