Hypomagnesemia as a Risk Factor and Accelerator for Vascular Aging in Diabetes Mellitus and Chronic Kidney Disease

Abstract

The age-old axiom that one is as old as his or her vessels are, calls for ongoing critical re-examination of modifiable risk factors of accelerated vascular ageing in chronic kidney diseases. Attempts to modulate vascular risk with cholesterol-lowering agents have largely failed in advanced chronic kidney disease (CKD). In addition to nitrogen waste products, many pathological biochemical processes also play a role in vascular calcification in chronic kidney damage. Magnesium, a cation vital for the body, may substantially reduce cardiovascular diseases’ risk and progression. This narrative review aimed to address the relationship between hypomagnesemia and vascular calcification, which promotes further cardiovascular complications in diabetes, aging, and CKD. Articles with predefined keywords were searched for in the PubMed and Google Scholar databases with specific inclusion and exclusion criteria. We hypothesized that a decrease in serum magnesium levels contributes to increased vascular calcification and thereby increases cardiovascular mortality. In summary, based on existing evidence in the literature, it appears that simple and inexpensive oral magnesium supplementation may reduce the cardiovascular mortality of patients who are already severely affected by such diseases; in this context, the concept of ‘normal’ vs. ‘ideal’ serum magnesium levels should be carefully re-examined.

Incidence of Dysmagnesemia among Medically Hospitalized Patients and Associated Clinical Characteristics: A Prospective Cohort Study

“…While kidney disease can lead to both low and elevated Mg concentrations, our findings indicate that patients with CKD are more likely to develop hypermagnesemia similar to what others have reported [ 6 ]. Hypomagnesemia is also common in CKD, especially if the patient is on a diuretic medication [ 20 ]. Mg wasting via dialysis is the main reason for hypomagnesemia in end-stage renal disease [ 20 ].…”

“…Hypomagnesemia is also common in CKD, especially if the patient is on a diuretic medication [ 20 ]. Mg wasting via dialysis is the main reason for hypomagnesemia in end-stage renal disease [ 20 ]. Mg supplement was found to have a protective effect in dialysis-dependent patients, and Sakaguchi et al documented that hypermagnesemia had a survival benefit in ESRD patients on hemodialysis [ 21 ].…”

Hemoglobin level and erythropoietin response in hemodialysis patients: what can we pay attention to?

“…In addition to the above, secondary hyperparathyoidism is one of the main causes of EPO resistance in HD patients, the review by Petho et al. [ 5 ] showed that a significant negative correlation between serum magnesium and intact parathyroid hormone(PTH) in ESKD patients, as well as oral magnesium supplementation alone in HD patients improved chronic kidney disease-mineral bone disease by modulating serum Ca and PTH metabolism.…”

Magnesium Is a Vital Ion in the Body—It Is Time to Consider Its Supplementation on a Routine Basis

“…The correlation between renal magnesium loss and extensive coronary and vascular calcifications has been firmly established because of the genetic mutation 17q12 [ 24 ]. We recently published a narrative review of the connection between hypomagnesemia and cardiovascular disease [ 25 ]. In our study, we noted that a lack of magnesium was closely correlated with general atherosclerosis.…”