Lower serum magnesium is associated with vascular calcification in peritoneal dialysis patients: a cross sectional study

Abstract

BackgroundCoronary artery calcification (CAC) is highly prevalent among dialysis patients and is associated with increased cardiovascular and all cause mortality. Magnesium (Mg) inhibits vascular calcification in animal and in-vitro studies but whether the same effect occurs in humans is uncertain.MethodsA single centre cross-sectional study of 80 prevalent peritoneal dialysis (PD) patients; on PD only for a minimum of 3 months. A radiologist blinded to patient status calculated their abdominal aortic calcification (AAC) scores on lateral lumbar spine radiographs, a validated surrogate for CAC.ResultsEighty patients provided informed consent and underwent lumbar spine radiography. The mean serum Mg was 0.8 mmol/L (standard deviation 0.2) and mean AAC score 8.9 (minimum 0, maximum 24). A higher serum Mg level was associated with a lower AAC score (R 2 = 0.06, unstandardized coefficient [B] = −7.81, p = 0.03), and remained after adjustment for age, serum phosphate, serum parathyroid hormone, low-density lipoprotein cholesterol, smoking history, and diabetes (model adjusted R 2 = 0.36, serum Mg and AAC score B = −11.44, p = 0.00). This translates to a 0.1 mmol/L increase in serum Mg being independently associated with a 1.1-point decrease in AAC score.ConclusionsOur findings suggest that Mg may inhibit vascular calcification. If this association is replicated across larger studies with serial Mg and vascular calcification measurements, interventions that increase serum Mg and their effect on vascular calcification warrant further investigation in the PD population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0549-y) contains supplementary material, which is available to authorized users.

Current and potential therapeutic strategies for the management of vascular calcification in patients with chronic kidney disease including those on dialysis

“…104 Serum magnesium concentration <0.8 mmol/L has been associated with a 36% increased risk of death from coronary artery disease 105,106 and 2 meta-analyses report serum magnesium is inversely associated with cardiovascular risk in both healthy controls and hemodialysis cohorts. 107,108 Similar findings were seen in a study of 80 patients on peritoneal dialysis, 109…”

“…Serum magnesium concentration <0.8 mmol/L has been associated with a 36% increased risk of death from coronary artery disease and 2 meta‐analyses report serum magnesium is inversely associated with cardiovascular risk in both healthy controls and hemodialysis cohorts . Similar findings were seen in a study of 80 patients on peritoneal dialysis, with higher serum magnesium associated with less abdominal aortic calcification ( R 2 = .06, unstandardized coefficient [B] = −7.81, P = .03). Magnesium has also been reported to delay CPP maturation and transition from primary to secondary CPP in hemodialysis patients by slowing calcification propensity.…”

Abdominal aortic calcification score predicts the occurrence of coronary artery disease in middle‐aged peritoneal dialysis patients

“…We did not know the exact reasons why these factors were not positively correlated with AAC. Low serum magnesium level was also shown to be associated with vascular calcification in a cross-sectional study in PD patients, 19 and did not significantly affect AAC score in our study either. Coronary artery disease is highly prevalent in ESRD patients and results in a high mortality rate.…”

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

“…Limited information is currently available on the effects of Mg on arrhythmia, but Alabd et al reported that the post-dialysis QTc interval duration inversely correlated with a decrease in serum Mg levels during the HD session [61]. Table 1 shows observational studies that examined the relationship between serum Mg levels and cardiovascular calcification/atherosclerosis in CKD/ESRD patients [32,[62][63][64][65][66][67][68]. Most of these studies indicated an association between hypomagnesemia and cardiovascular lesions.…”