Low plasma magnesium concentration and future abdominal aortic calcifications in moderate chronic kidney disease

Braake, Anique D. ter; Govers, Larissa P.; Peeters, Mieke J.; Zuilen, Arjan D. van; Wetzels, Jack F.M.; Blankenstijn, Peter J.; Hoenderop, Joost G. J.; Baaij, Jeroen H. F. de; Brand, Jan van den

doi:10.1186/s12882-021-02267-4

Cited by 4 publications

(3 citation statements)

References 41 publications

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“…found that higher serum magnesium levels were significantly associated with lower abdominal aortic calcification volume in ESKD patients [ 26 ]. Observational studies on dialysis patients have shown that higher blood magnesium concentration is associated with a lower risk of vascular calcification [ 27 , 28 ]. Both in vitro and in vivo models have demonstrated that magnesium can prevent the transdifferentiation of osteoblastic vascular smooth muscle cells [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

The serum levels of gasdermin D in uremic patients and its relationship with the prognosis: a prospective observational cohort study

Zhang,

Yang

2024

Renal Failure

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Objective This study aimed to explore the serum levels of gasdermin D (GSDMD) in uremic (end-stage kidney disease, ESKD) patients and their correlation with vascular calcification (VC) and clinical results. Methods This prospective observational cohort study enrolled 213 ESKD patients who were undergoing regular maintenance hemodialysis (MHD) for > 3 months in our hospital from August 2019 to July 2022. The abdominal aortic calcification score (AACS) was used to assess the VC condition of patients with ESKD. Serum GSDMD, caspase-1, interleukin (IL)-6, IL-1β, IL-18 and C-reactive protein (CRP) levels were measured using enzyme-linked immunosorbent assay (ELISA). Demographic and clinical data were obtained. All patients were followed up for 1 year, and patients with major adverse cardiovascular events (MACE) were defined as having a poor prognosis. All data used SPSS 26.0 to statistical analyses. Results The serum total cholesterol (TC) levels of patients in the AACS > 4 group were significantly elevated compared with those in the AACS ≤ 4 group. In addition, ESKD patients with an AACS > 4 had significantly higher serum levels of GSDMD, caspase-1, IL-6, IL-18 and IL-1β. Moreover, Pearson’s analysis supported a positive correlation between GSDMD and caspase-1, IL-6, and IL-1β. In addition, we found that GSDMD levels were positively correlated with the clinical data (AACS scores and serum TC levels) of patients with ERSD. Additionally, ROC curves showed that the serum levels of GSDMD could be a potential predictive biomarker of moderate/severe VC and prognosis in patients with ESKD. Finally, the results of logistic regression indicated that GSDMD and AACS scores were risk factors for poor prognosis in patients with ESKD. Conclusion Serum GSDMD levels were remarkably elevated in patients with ESKD with moderate/severe calcification. In addition, serum levels of GSDMD could be a potential predictive biomarker of moderate/severe VC and prognosis in patients with ESKD.

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Section: Discussionmentioning

confidence: 99%

The serum levels of gasdermin D in uremic patients and its relationship with the prognosis: a prospective observational cohort study

Zhang,

Yang

2024

Renal Failure

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“…Low serum Mg was found associated with the prevalence and incidence of aortic valve calcification in an adult population without known CVD and CKD [ 44 ]. In moderate CKD, low serum Mg was associated with abdominal aortic calcification, increased pulse pressure, mitral valve calcification and increased intima media thickness [ 45 , 46 , 47 ]. The findings that decreased levels of GRP and Mg and increased levels of P are independent and cumulative risk factors of VC, are in line with the current knowledge of their involvement on the pathophysiological mechanisms of cardiovascular calcification, and reinforce the crucial role of bone mineral metabolism in cardiovascular risk.…”

Section: Discussionmentioning

confidence: 99%

Gla-Rich Protein, Magnesium and Phosphate Associate with Mitral and Aortic Valves Calcification in Diabetic Patients with Moderate CKD

et al. 2022

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Accelerated and premature cardiovascular calcification is a hallmark of chronic kidney disease (CKD) patients. Valvular calcification (VC) is a critical indicator of cardiovascular disease and all-cause mortality in this population, lacking validated biomarkers for early diagnosis. Gla-rich protein (GRP) is a cardiovascular calcification inhibitor recently associated with vascular calcification, pulse pressure, mineral metabolism markers and kidney function. Here, we examined the association between GRP serum levels and mitral and aortic valves calcification in a cohort of 80 diabetic patients with CKD stages 2–4. Mitral and aortic valves calcification were detected in 36.2% and 34.4% of the patients and associated with lower GRP levels, even after adjustments for age and gender. In this pilot study, univariate, multivariate and Poisson regression analysis, show that low levels of GRP and magnesium (Mg), and high levels of phosphate (P) are associated with mitral and aortic valves calcification. Receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) values of GRP for mitral (0.762) and aortic (0.802) valves calcification were higher than those of Mg and P. These results suggest that low levels of GRP and Mg, and high levels of P, are independent and cumulative risk factors for VC in this population; the GRP diagnostic value might be potentially useful in cardiovascular risk assessment.

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“…Notwithstanding all these risk factors created in the context of CKD, hypomagnesemia is yet another interesting and underappreciated risk factor for cardiovascular mortality. Observational data have shown an association between low serum magnesium concentrations or magnesium intake and the increased risk of atherosclerosis, coronary artery disease, arrhythmias, aortic valve calcification [ 47 , 48 , 49 , 50 ], and heart failure [ 51 ]. Furthermore, low serum magnesium levels were associated with an increased risk of end-stage renal disease associated with high serum phosphate levels in a cohort study, suggesting a strong relationship between magnesium deficiency and the adverse effects of high phosphate levels.…”

Section: Cardiovascular Mortality In Chronic Kidney Diseasementioning

confidence: 99%

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

et al. 2023

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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.

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Low plasma magnesium concentration and future abdominal aortic calcifications in moderate chronic kidney disease

Cited by 4 publications

References 41 publications

The serum levels of gasdermin D in uremic patients and its relationship with the prognosis: a prospective observational cohort study

The serum levels of gasdermin D in uremic patients and its relationship with the prognosis: a prospective observational cohort study

Gla-Rich Protein, Magnesium and Phosphate Associate with Mitral and Aortic Valves Calcification in Diabetic Patients with Moderate CKD

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

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