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Lower serum magnesium is associated with vascular calcification in peritoneal dialysis patients: a cross sectional
Amber O Molnar1, Mohan Biyani1, Ian Hammond2,3
1Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Insights
Magnesium may reduce vascular calcification in dialysis patients. Higher serum magnesium levels were linked to lower abdominal aortic calcification scores in peritoneal dialysis patients, suggesting a potential protective effect.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Biochemistry
Background:
- Coronary artery calcification (CAC) is common in dialysis patients, increasing mortality risk.
- Magnesium (Mg) shows potential in inhibiting vascular calcification in preclinical studies.
- Human data on magnesium's effect on vascular calcification, especially in dialysis populations, remains limited.
Purpose of the Study:
- To investigate the association between serum magnesium levels and abdominal aortic calcification (AAC) in peritoneal dialysis (PD) patients.
- To determine if magnesium plays a role in inhibiting vascular calcification in humans undergoing PD.
- To provide preliminary data for future interventional studies.
Main Methods:
- A cross-sectional study involving 80 prevalent peritoneal dialysis patients.
- Abdominal aortic calcification (AAC) scores were assessed using lateral lumbar spine radiographs by a blinded radiologist.
- Serum magnesium levels were measured and correlated with AAC scores, with adjustments for relevant clinical and biochemical parameters.
Main Results:
- A higher serum magnesium level was significantly associated with a lower AAC score (p=0.03).
- This association remained significant after adjusting for factors like age, phosphate, PTH, LDL, smoking, and diabetes (p=0.00).
- A 0.1 mmol/L increase in serum Mg corresponded to an independent 1.1-point decrease in AAC score.
Conclusions:
- Serum magnesium levels may be inversely associated with vascular calcification in PD patients.
- Magnesium supplementation could potentially be a therapeutic strategy to reduce vascular calcification in this population.
- Further large-scale studies with serial measurements are warranted to confirm these findings and explore interventions.
Background:
Coronary artery calcification (CAC) is highly prevalent among dialysis patients and is associated with increased cardiovascular and all cause mortality. Magnesium (Mg) inhibits vascular calcification in animal and in-vitro studies but whether the same effect occurs in humans is uncertain.
Methods:
A single centre cross-sectional study of 80 prevalent peritoneal dialysis (PD) patients; on PD only for a minimum of 3 months. A radiologist blinded to patient status calculated their abdominal aortic calcification (AAC) scores on lateral lumbar spine radiographs, a validated surrogate for CAC.
Results:
Eighty patients provided informed consent and underwent lumbar spine radiography. The mean serum Mg was 0.8 mmol/L (standard deviation 0.2) and mean AAC score 8.9 (minimum 0, maximum 24). A higher serum Mg level was associated with a lower AAC score (R 2 = 0.06, unstandardized coefficient [B] = -7.81, p = 0.03), and remained after adjustment for age, serum phosphate, serum parathyroid hormone, low-density lipoprotein cholesterol, smoking history, and diabetes (model adjusted R 2 = 0.36, serum Mg and AAC score B = -11.44, p = 0.00). This translates to a 0.1 mmol/L increase in serum Mg being independently associated with a 1.1-point decrease in AAC score.
Conclusions:
Our findings suggest that Mg may inhibit vascular calcification. If this association is replicated across larger studies with serial Mg and vascular calcification measurements, interventions that increase serum Mg and their effect on vascular calcification warrant further investigation in the PD population.