Hypomagnesemia and atherogenic dyslipidemia in chronic kidney disease: surrogate markers for increased cardiovascular risk

Dey, Ritwik; Rajappa, Medha; Parameswaran, Sreejith; Revathy, G.

doi:10.1007/s10157-015-1097-z

Cited by 19 publications

(20 citation statements)

References 30 publications

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“…Hypomagnesemia is a recognized risk for cardiac rhythm disturbances and is associated with a higher risk for cardiovascular events (3). There is also growing evidence supporting an association between lower serum magnesium levels and dyslipidemia, metabolic syndrome, endothelial dysfunction, atherosclerosis, and vascular calcification, all of which could potentially be mechanisms to explain the observations in our study (15–19). Second, infection is an ongoing threat to the successful execution of PD.…”

Section: Discussionsupporting

confidence: 54%

Serum Magnesium Levels and Hospitalization and Mortality in Incident Peritoneal Dialysis Patients: A Cohort Study

Yang

Soohoo

Streja

et al. 2016

American Journal of Kidney Diseases

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Background Prior studies have shown the association of low serum magnesium with adverse health outcomes in patients undergoing hemodialysis. There is a paucity of such studies in patients undergoing peritoneal dialysis (PD). Study Design Cohort Study. Setting & Participants 10,692 patients treated with PD January 1, 2007–December 31, 2011 in facilities operated by a single large dialysis organization in the United States. Predictor Baseline serum magnesium levels, examined as five categories (<1.8, 1.8–<2.0, 2.0–<2.2 [reference], 2.2–<2.4, and ≥2.4 mg/dL). Outcomes Time to first hospitalization and time to death using competing risks regression models. Results The distribution of baseline serum magnesium levels in the cohort were < 1.8 mg/dl: 1928 (18%); 1.8–<2.0 mg/dl: 2204 (21%); 2.0–<2.2 mg/dl: 2765 (26%); 2.2–<2.4 mg/dl: 1765 (16%); and ≥ 2.4 mg/dl: 2030 (19%). Of the 10,692 patients, 6465 (60%) were hospitalized at least once and 1392 (13%) died during follow-up (median, 13; IQR, 7–23 months). Baseline serum magnesium <1.8 mg/dL was associated with higher risk for hospitalization and all-cause mortality after adjustment for demographic and clinical characteristics (adjusted HRs of 1.23 [95% CI, 1.14–1.33] and 1.21 [95% CI, 1.03–1.42], respectively). The higher risk for hospitalization persisted upon adjustment for laboratory variables while that for all-cause mortality was attenuated to a non-significant level. The greatest risk for hospitalization was in patients with low serum albumin (< 3.5 g/dl; p for interaction < 0.001). Limitations Possibility of residual confounding by unmeasured variables cannot be excluded. Conclusions Lower serum magnesium levels may be associated with higher risk of hospitalization in incident PD patients, particularly among those with hypoalbuminemia. Additional studies are needed to confirm these findings and investigate whether correction of hypomagnesemia reduces these risks.

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Section: Discussionsupporting

confidence: 54%

Serum Magnesium Levels and Hospitalization and Mortality in Incident Peritoneal Dialysis Patients: A Cohort Study

Yang

Soohoo

Streja

et al. 2016

American Journal of Kidney Diseases

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“…One animal study [29] postulated a favorable effect of magnesium on lipid metabolism in the conversion of triglycerides to high-density lipoprotein (HDL) cholesterol. This relationship is supported by epidemiological studies [30][31][32] in which the serum magnesium level was inversely associated with total, low-density lipoprotein, and non-HDL cholesterol and positively associated with HDL cholesterol. One of the mechanisms by which magnesium lowers blood pressure is by acting as a natural calcium channel blocker.…”

Section: Discussionsupporting

confidence: 50%

Low Magnesium Levels in Adults with Metabolic Syndrome: a Meta-Analysis

Lee

Kim

et al. 2015

Biol Trace Elem Res

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“…[26][27][28] It has been reported that atherogenic dyslipidemia and systemic inflammation are symptoms commonly seen in patients with CKD due to metabolic disturbances and the accumulation of vasotoxic substances. [29][30][31] In addition, ongoing endothelial damage in the capillary system of the renal medulla with vascular rarefaction is unfavorably associated with developing CKD. 32 On the other hand, evidence suggests that regular exercise confers cardiometabolic benefits and structural and functional adaptations of the endothelial response to vasoconstrictors.…”

Section: Principal Findingsmentioning

confidence: 99%

Association of Cardiorespiratory Fitness and Hemodynamic Responses to Submaximal Exercise Testing With the Incidence of Chronic Kidney Disease: The Framingham Heart Study

Lee

Song

Vasan

et al. 2020

Mayo Clinic Proceedings

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Objective: To relate cardiorespiratory fitness (CRF) and hemodynamic responses to exercise to the incidence of chronic kidney disease (CKD). Methods: We evaluated 2715 Framingham Offspring Study participants followed up (mean, 24.8 years) after their second examination (1979)(1980)(1981)(1982)(1983) until the end of their ninth examination (2011)(2012)(2013)(2014). Participants (mean age, 43 years; 1397 women [51.5%]) without prevalent CKD or cardiovascular disease at baseline were included. We examined the associations of CRF and hemodynamic response to exercise with incident CKD using multivariable Cox proportional hazards regression with discrete intervals. Results: Compared with low CRF (first tertile), participants with moderate (second tertile) or high (third tertile) CRF had a lower risk of CKD (hazard ratios [95% CIs]: 0.74 [0.61-0.91] and 0.73 [0.59-0.91], respectively). Participants with chronotropic incompetence (hazard ratio, 1.38 [95% CI, 1.06 to 1.79]), higher exercise systolic blood pressure (hazard ratio per SD, 1.20 [95% CI, 1.07 to 1.34]), and impaired heart rate recovery (hazard ratio, 1.51 [95% CI, 1.08 to 2.10]) had a higher risk of CKD compared with those with chronotropic competence, lower exercise systolic blood pressure, and normal heart rate recovery, respectively. These associations remained robust when the exercise variables were mutually adjusted for. The third tertile of a standardized exercise test score comprising the statistically significant variables was associated with a higher risk of CKD compared with the first tertile (hazard ratio, 1.85; 95% CI, 1.45 to 2.36). Conclusion: Higher CRF and favorable hemodynamic responses to submaximal exercise in young adulthood may be markers of lower risk of CKD in later life.

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Hypomagnesemia and atherogenic dyslipidemia in chronic kidney disease: surrogate markers for increased cardiovascular risk

Cited by 19 publications

References 30 publications

Serum Magnesium Levels and Hospitalization and Mortality in Incident Peritoneal Dialysis Patients: A Cohort Study

Serum Magnesium Levels and Hospitalization and Mortality in Incident Peritoneal Dialysis Patients: A Cohort Study

Low Magnesium Levels in Adults with Metabolic Syndrome: a Meta-Analysis

Association of Cardiorespiratory Fitness and Hemodynamic Responses to Submaximal Exercise Testing With the Incidence of Chronic Kidney Disease: The Framingham Heart Study

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