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Published on: November 3, 2023
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Preoperative Ionized Magnesium Levels and Risk of Acute Kidney Injury After Cardiac Surgery
Hee Byung Koh1, Chan-Young Jung1, Hyung Woo Kim1
1Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea.
Summary
Lower preoperative serum magnesium levels were linked to a higher risk of acute kidney injury (AKI) after cardiac surgery. This finding highlights the importance of magnesium levels in preventing kidney complications post-operation.
Area of Science:
- Nephrology
- Cardiology
- Critical Care Medicine
Background:
- Postoperative acute kidney injury (AKI) is a significant complication following cardiac surgery.
- Preventive strategies for AKI remain limited.
- Preoperative low magnesium levels are associated with atrial fibrillation after cardiac surgery, but their link to AKI is unclear.
Purpose of the Study:
- To investigate the association between preoperative serum magnesium concentration and the incidence of AKI after cardiac surgery.
- To determine if lower magnesium levels increase the risk of AKI and dialysis-treated AKI.
Main Methods:
- Retrospective observational cohort study involving 9,766 adult patients undergoing cardiac surgery.
- Serum magnesium levels were measured preoperatively.
- Postoperative AKI was defined using Acute Kidney Injury Network (AKIN) criteria within 48 hours.
- Dialysis-treated AKI within 30 days was also assessed.
- Multivariable logistic regression analysis was employed to evaluate associations.
Main Results:
- 40.1% of patients developed postoperative AKI, and 4.3% required dialysis.
- Lower quartiles of preoperative serum magnesium were associated with a higher prevalence of AKI.
- Adjusted odds ratios for AKI increased with decreasing magnesium levels (e.g., OR 1.53 for the lowest quartile vs. highest).
- Preoperative hypomagnesemia (<1.09mg/dL) was significantly associated with both AKI (aOR 1.39) and dialysis-treated AKI (aOR 1.67).
Conclusions:
- Lower preoperative serum magnesium levels are significantly associated with an increased incidence of AKI after cardiac surgery.
- This association persists even after adjusting for other risk factors.
- Maintaining adequate magnesium levels may be a potential strategy for AKI prevention in cardiac surgery patients.
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