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Bone and vascular effects of magnesium supplements in CKD patients (the MagicalBone Pilot Study)
María Victoria Pendón-Ruiz de Mier1, Rafael Santamaría1, Cayetana Moyano-Peregrín2
1Nephrology Service, Reina Sofia University Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Spain; RICORS2040, Madrid, Spain.
Insights
Magnesium carbonate supplementation in chronic kidney disease (CKD) patients improved vascular compliance but did not affect bone density. Monitoring urinary magnesium is recommended for CKD patients.
Area of Science:
- Nephrology
- Cardiology
- Mineral Metabolism
Background:
- Chronic kidney disease (CKD) progression involves mineral metabolism alterations linked to cardiovascular and bone disease.
- Hypomagnesemia in CKD patients correlates with faster disease progression and comorbidities.
- Understanding magnesium's role is crucial for managing CKD complications.
Purpose of the Study:
- To investigate the effects of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes, specifically vascular calcification (VC), in CKD stages 3-4 patients.
- To assess the impact of Mg supplementation on vascular compliance and bone metabolism markers.
Main Methods:
- Randomized controlled trial involving CKD stages 3-4 patients (n=19).
- Intervention group received 360mg Mg carbonate daily for 15 months; control group did not.
- Evaluated mineral metabolism, BMD, VC (Adragao index), and pulse wave velocity (PWV).
Main Results:
- Mg supplementation increased urinary Mg excretion; serum Mg and bone mineral density remained unchanged.
- No significant changes in vascular calcification were observed.
- A significant association was found between serum and urine Mg levels and decreased PWV, indicating improved vascular compliance.
- Serum Mg correlated with N-terminal propeptide of collagen alpha-1(I) chain (PINP), a bone formation marker.
Conclusions:
- Magnesium supplementation may offer benefits for vascular compliance in CKD patients without negatively impacting bone status.
- Monitoring urinary magnesium levels is important in CKD patients.
- Further research is needed to fully elucidate magnesium's role in CKD progression and management.
Background And Objective:
The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC).
Material And Methods:
Patients with CKD stages 3-4 were randomized into controls (n=12) or intervention (n=7) group receiving 360mg of Mg carbonate daily during a 15-month period. Parameters related to mineral metabolism, BMD, VC, and pulse wave velocity (PWV) were evaluated.
Results:
Supplementation with Mg produced an increase in the urinary excretion of Mg while serum Mg levels remained stable and no episodes of hypermagnesemia were reported. In addition, no significant changes were found in the degree of VC assessed by Adragao index, however, both serum and urine Mg were significantly associated with a decrease in PWV, suggesting an increase in vascular compliance. Likewise, BMD did not change following treatment, but serum Mg significantly correlated with the levels of N-terminal propeptide of collagen alpha-1(I) chain (PINP), a marker of bone synthesis.
Conclusions:
In sum, these results suggest a possible beneficial effect of Mg on vascular compliance with no detrimental effects on bone status. In addition, our results highlight the need to consider monitorization of urinary Mg status in CKD patients.
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