Clinical significance of fractional magnesium excretion (FEMg) as a predictor of interstitial nephropathy and its correlation with conventional parameters

Noiri, Eisei; Shimizu, Taisuke; Takayanagi, Kaori; Tayama, Yosuke; Iwashita, Takatsugu; Okazaki, Shimpei; Hatano, Minoru; Matsumura, Osamu; Kato, Hitoshi; Matsuda, Akihiko; Mitarai, Tetsuya; Hasegawa, Hajime

doi:10.1007/s10157-015-1099-x

Cited by 15 publications

(14 citation statements)

References 19 publications

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“…Glomerular filtration of Mg decreases as CKD progresses, whereas tubular reabsorption of Mg is impaired due to tubulointerstitial injury, thus causing an increase in fractional Mg excretion [17,18]. However, the quantitative excretion of Mg tends to decrease regardless of the compensatory increase in fractional Mg excretion if glomerular filtration rate (GFR) falls to < 30 mL/min/ 1.73 m 2 [19], particularly < 10-15 mL/min/1.73 m 2 [20,21].…”

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confidence: 99%

Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions

Ikee¹

2018

Ren Replace Ther

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Magnesium (Mg) is an essential element that plays pivotal roles in a number of biological processes in the human body. Hypomagnesemia is involved in the pathophysiology of hypertension, vascular calcification, and metabolic derangements including diabetes mellitus and dyslipidemia, which are all risk factors for cardiovascular disease, the leading cause of mortality and morbidity in patients with chronic kidney disease (CKD). Hypomagnesemia is also associated with the development and progression of CKD. As CKD advances, renal Mg excretion decreases and hypermagnesemia emerges in end-stage renal disease (ESRD). In addition, dialysates with high Mg concentrations, which were used in the early era of dialysis therapy, increased the risk of hypermagnesemia, and thus, the dialysate Mg composition has since been reduced. Accordingly, dialysis patients in the modern era commonly have normomagnesemia or even hypomagnesemia. The relationships between hypomagnesemia and cardiovascular disease and mortality have been increasingly reported in observational studies in CKD/ESRD. However, these relationships may be attenuated by a patient's race or region. Although dialysates with higher Mg concentrations or Mg-containing phosphate binders appear to be promising in this setting, only a few interventional studies have examined the effects of Mg supplementation on cardiovascular lesions. Furthermore, the effects of Mg supplementation on mortality have not yet been investigated as a primary end-point in randomized controlled trials. Further studies are required in order to establish the efficacy and safety of Mg in CKD patients.

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confidence: 99%

Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions

Ikee¹

2018

Ren Replace Ther

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“…Fractional excretion of magnesium level is a significant predictor of glomerular disorder or tubulo‐interstitial nephropathy. A recent study by Noiri et al () revealed a negative correlation between FEMg level and eGFR among paticipants with an eGFR of less than 30 mL/min. However, this study showed a significant negative correlation between FEMg level and eGFR among participants with normal eGFRs.…”

Section: Discussionmentioning

confidence: 91%

Can a community‐based multidisciplinary intervention effectively restore renal function? A non‐randomized clinical trial

Phuphaibul

Teamprathom²,

Puckpinyo

et al. 2016

Nursing & Health Sciences

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There is insufficient evidence in the literature to indicate whether the promotion of lifestyle changes to prevent renal dysfunction and activate regeneration is effective. We examined the effectiveness of a community-based intervention program on renal restoration using a non-randomized clinical trial design with a follow-up period of six months. The training focused on lifestyle changes, including health education and personal consultation with a multidisciplinary health team. Our study included 120 patients with fractional excretion of magnesium levels of > 2%, who were assigned to experimental or control groups. Fractional excretion of magnesium levels were significantly decreased within six months in the experimental group; however, changes in the estimated glomerular filtration rate were not identified in either of the groups. These results suggest that screening of the fractional excretion of magnesium level and the "Healthy Kidney Program" had an effect in preventing chronic kidney disease or restoring kidney function.

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“…In addition, the highest mean of FEMg (7.96 ± 4.08%) was found in the highest PTH quartile (> 89.5pg / mL). According to Dai et al [28], PTH improves the absorption of magnesium in the distal contoured tubule and the increase in FEMg in patients with CKD in the early stages, works as a compensatory mechanism to keep serum serum Mg levels within the normal range [29]. In CKD, studies on the relationship between PTH and serum Mg were preferably performed in dialysis patients and showed an inverse association between these variables [30,31], but prospective studies on this effect in non-dialysis patients are lacking.…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Serum Parathormone Levels With Urinary Magnesium Excretion in Patients With Non-Dialytic Chronic Kidney Disease

Dias

Brito

Lages

et al. 2020

Preprint

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Background: Disorders of mineral metabolism occur in most patients with chronic kidney disease (CKD). The aim of this work was to correlate serum parathyroid hormone (PTH) levels with urinary magnesium excretion in patients with non-dialysis CKD. Methods: Cross-sectional study with patients with CKD undergoing non-dialysis treatment in stages 3A, 3B and 4. Concentrations of creatinine, magnesium, calcium, phosphorus, parathyroid hormone, vitamin D and alkaline phosphatase were determined in blood samples. The assessment of urinary magnesium levels was performed by means of total daily excretion and by the excretion fraction (FEMg). Results: The study evaluated 163 patients with mean age of 60.7 ± 11.7 and 51.0% were male. A positive correlation was observed between PTH and alkaline phosphatase (r = 0.26; p = 0.006) and FEMg (r = 0.17; p = 0.020). Calcium (r = -0.23; p = 0.002), magnesium in 24-hour urine (r = -0.18; p = 0.020) and estimated glomerular filtration rate (r = -0.47; p = 0.001) demonstrated negative correlation with PTH. Conclusion: Elevated levels of PTH correlated positively with FEMg, regardless of the presence of serum magnesium alterations, and FEMg can be used as another indicator for the treatment of hyperparathyroidism.

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Clinical significance of fractional magnesium excretion (FEMg) as a predictor of interstitial nephropathy and its correlation with conventional parameters

Abstract: Our findings may indicate that the combination of the FEMg and the NAG index can provide a specific, sensitive assessment for TIN in patients without renal insufficiency.

Cited by 15 publications

References 19 publications

Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions

Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions

Can a community‐based multidisciplinary intervention effectively restore renal function? A non‐randomized clinical trial

Correlation Between Serum Parathormone Levels With Urinary Magnesium Excretion in Patients With Non-Dialytic Chronic Kidney Disease

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