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The association between circulating magnesium and clinically relevant outcomes in patients with chronic kidney

Nicoline H J Leenders1, Emma A Vermeulen1, Adriana J van Ballegooijen2

  • 1Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Clinical Nutrition (Edinburgh, Scotland)
|January 9, 2021
PubMed

Insights

Higher plasma magnesium levels are linked to reduced mortality and cardiovascular events in chronic kidney disease (CKD) patients. This suggests magnesium may be a key factor in improving outcomes for individuals with CKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Chronic kidney disease (CKD) patients face high risks for cardiovascular disease and mortality despite current treatments.
  • Observational studies suggest a link between magnesium levels and various clinical outcomes in CKD patients.
  • The precise association between plasma magnesium and adverse events in CKD requires further systematic investigation.

Purpose of the Study:

  • To systematically review and meta-analyze longitudinal studies on plasma magnesium concentration and clinical outcomes in adult CKD patients.
  • To assess the association between magnesium levels and key outcomes including all-cause mortality, cardiovascular mortality, cardiovascular events, sudden death, and hospitalization.
  • To provide a comprehensive overview of existing evidence to guide future research.

Main Methods:

  • A systematic literature search was conducted across PubMed, Embase, and The Cochrane Library for studies on plasma magnesium and CKD.
  • Two independent authors selected eligible studies, and study quality was assessed using the Newcastle-Ottawa Scale.
  • A random-effects meta-regression analysis was employed to pool results from comparable studies.

Main Results:

  • The search identified 33 eligible studies with data from 348,059 patients; 22 studies were included in the final meta-analysis.
  • Higher plasma magnesium concentrations were associated with a significantly lower risk of all-cause mortality (HR 0.90 [0.87-0.94] per 0.1 mmol/L increase).
  • Elevated magnesium levels also correlated with reduced risk for cardiovascular mortality and events (HR 0.85 [0.77-0.94] per 0.1 mmol/L increase).

Conclusions:

  • Plasma magnesium concentration demonstrates an inverse relationship with all-cause mortality and cardiovascular mortality/events in CKD patients.
  • Increasing magnesium levels may offer a therapeutic strategy to mitigate risks in individuals with chronic kidney disease.
  • This meta-analysis provides a strong foundation for prospective trials to confirm the beneficial effects of elevated plasma magnesium on clinical outcomes.
Abstract

Keywords:
CardiovascularChronic kidney diseaseDialysisEnd-stage renal diseaseMagnesiumMortality

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