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Magnesium supplementation: A consideration in dialysis patients
Mugurel Apetrii1, Adrian Covic1, Ziad A Massy2,3
1Department of Nephrology, University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania.
Seminars in Dialysis
|October 25, 2017
Summary
Magnesium (Mg) balance disorders are common in dialysis patients but often overlooked. Supplementing Mg may improve patient outcomes by potentially reducing phosphate levels and mortality, warranting further research.
Area of Science:
- Nephrology
- Mineral Metabolism
- Dialysis Patient Care
Background:
- Disorders of magnesium (Mg) balance are prevalent in patients undergoing dialysis, yet this essential cation is frequently neglected.
- Serum Mg levels in dialyzed patients are influenced by various factors, including dietary intake, medications (e.g., antacids, phosphate binders), and the dialysis prescription itself.
Discussion:
- Magnesium supplementation shows potential benefits in reducing serum phosphate concentration and parathyroid hormone (PTH) levels.
- Mg may play a role in mitigating vascular calcification and bone mineralization issues common in chronic kidney disease.
- While some studies suggest Mg supplementation could decrease all-cause and cardiovascular mortality, current evidence remains conflicting.
Key Insights:
- Despite conflicting data on mortality benefits, a risk-benefit assessment suggests targeting high-normal serum Mg levels may be a viable strategy.
- Mg supplementation is a plausible option for improving the overall outcomes of patients on dialysis.
- Further research is essential to definitively establish the role and optimal use of Mg supplementation in this patient population.
Outlook:
- Future studies should focus on directly evaluating the impact of Mg supplementation on hard clinical endpoints in dialysis patients.
- Investigating optimal dosing strategies and long-term effects of Mg supplementation is crucial.
- Understanding the complex interplay between Mg, phosphate, PTH, and cardiovascular health in dialysis patients requires continued investigation.
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