Association Between Pre-Transplant Magnesemia and Post-Transplant Dysglycemia in Kidney Transplant Recipients

Abstract

Background: Serum magnesium (Mg) status in kidney transplant recipients has been a center of attention in the past few years. Current evidence suggests an association between pre-transplant hypomagnesemia and post-transplant hyperglycemia. Objective: The purpose of this study was to assess the associations of pre-transplant magnesemia with blood glucose disturbances within 6 months post-kidney transplantation. Methods: In this retrospective cohort, 89 first-time kidney transplant recipients with 6 months of follow-up were included. None of the participants had a positive history of rejection, pre-transplant history of diabetes mellitus or fasting plasma glucose ≥ 100 mg/dL. Results: Post-transplant diabetes mellitus (PTDM) and impaired fasting glucose (IFG) 6 months post-transplant was found in 7.9% and 41.6% of the study group, respectively. The mean pre-transplant serum Mg level was 1.92 ± 0.30 mg/dL in the study population (n = 89), and it was significantly lower in IFG (n = 37) and IFG/PTDM (n = 44) groups compared to normoglycemic (n = 45) recipients (1.83 ± 0.31 mg/dL vs. 2.00 ± 0.27 mg/dL, P = 0.008, and 1.84 ± 0.31 mg/dL vs. 2.00 ± 0.27 mg/dL, P = 0.012, respectively). Patients with serum Mg less than 1.9 mg/dL were nearly 2.6 times more likely to develop IFG or IFG/PTDM within 6 months post-transplant (P = 0.044 and P = 0.040, respectively). Conclusions: Pre-transplant hypomagnesemia may be considered a risk factor for developing post-transplant glycemic disturbances, and patients with lower pre-transplant Mg concentration could be at a higher risk for developing IFG.

Calcineurin-Inhibitor-Induced Hypomagnesemia in Kidney Transplant Patients: A Monocentric Comparative Study between Sucrosomial Magnesium and Magnesium Pidolate Supplementation

“…Although pretransplant hypomagnesemia was associated with post-transplant dysglycemia, in our study, glycemic metabolism was unchanged with both Ultramag ® and Mag2 ® [18]. However, the screening of new-onset diabetes after transplantation should consider the possible consequence of the induction of immunosuppressive therapy with a high dose of corticosteroids, which might promote glucose intolerance via increasing insulin resistance and reducing insulin sensitivity.…”

Actualización sobre el papel de la terapia nutricional en pacientes sometidos a trasplante renal: de la enfermedad renal al trasplante

“…La incidencia varía del 2 al 50% en TR, según los criterios utilizados para el diagnóstico, la duración del seguimiento y el régimen inmunosupresor. Este trastorno metabólico no solo aumenta el riesgo de ECV e infecciones, sino que también afecta la supervivencia del paciente y del injerto 33 .…”