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Improved bone morphology by normalizing serum magnesium in chronically hemodialyzed patients
M Gonella1, P Ballanti, C Della Rocca
1Servizio di Nefrologia e Dialisi, Ente Ospedaliero, Casale Monferrato, Italia.
Mineral and Electrolyte Metabolism
|January 1, 1988
Summary
Reducing dialysate magnesium (dMg) in hemodialysis patients improved serum magnesium levels and reduced osteomalacia. This suggests optimizing dMg is crucial for bone health in chronic kidney disease patients.
Area of Science:
- Nephrology
- Mineral Metabolism
- Bone Biology
Background:
- Patients on chronic hemodialysis (RDT) often have altered mineral metabolism.
- Hypermagnesemia in RDT patients may be linked to high bone magnesium content, potentially impairing bone mineralization.
Purpose of the Study:
- To investigate the effect of reducing dialysate magnesium concentration (dMg) on serum magnesium levels and bone biopsy findings in RDT patients.
- To assess the impact of lower dMg on osteomalacia and bone resorption patterns.
Main Methods:
- A group of RDT patients had their dMg reduced from 1 to 0.5 mEq/l for 1 year.
- Serum parameters and bone biopsy data were collected before and after the intervention.
- All patients received calcium carbonate supplementation throughout the study.
Main Results:
- Serum magnesium (sMg) significantly decreased and normalized with lower dMg.
- Serum phosphorus increased slightly but remained within normal limits; other serum parameters showed no significant changes.
- A significant reduction in osteomalacia indicators (osteoid volume, surface, thickness) was observed.
- Bone resorption patterns (resorption surface, osteoclasts) did not vary significantly.
Conclusions:
- Normalizing sMg in RDT patients is recommended by adjusting dMg based on individual needs.
- Lowering dMg may improve bone mineralization by reducing bone magnesium content and addressing potential interference with the mineralization process.