Magnesemia in Renal Transplant Recipients: Relation With Immunosuppression and Posttransplant Diabetes

Osorio, J.M.; Bravo, José A.; Pérez, Ángela Fraga; Ferreyra, C.; Osuna, Antonio

doi:10.1016/j.transproceed.2010.08.016

Cited by 33 publications

(27 citation statements)

References 24 publications

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“…Osorio et al investigated this relationship among 589 nondiabetic KTR whose serum Mg measurements were performed throughout the first year post-transplant. 34 They reported no association between hypoMg and NODAT after adjustment for CNI regimen. In contrast, Van Laecke et al conducted a study of 390 KTR to assess the relation between hypoMg and NODAT, using serum Mg levels during the first 2 months after transplant.…”

Section: Discussionmentioning

confidence: 98%

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Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation

Huang

Famure

et al. 2015

JASN

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Several studies suggest a link between post-transplant hypomagnesemia and new-onset diabetes after transplantation (NODAT), but this relationship remains controversial. We conducted a retrospective cohort study of 948 nondiabetic kidney transplant recipients from January 1, 2000, to December 31, 2011, to examine the association between serum magnesium level and NODAT. Multivariable Cox proportional hazards models were fitted to evaluate the risk of NODAT as a function of baseline (at 1 month), timevarying (every 3 months), and rolling-average (i.e., mean for 3 months moving at 3-month intervals) serum magnesium levels while adjusting for potential confounders. A total of 182 NODAT events were observed over 2951.2 person-years of follow-up. Multivariable models showed an inverse relationship between baseline serum magnesium level and NODAT (hazard ratio [HR], 1.24 per 0.1 mmol/L decrease; 95% confidence interval [95% CI], 1.05 to 1.46; P=0.01). The association with the risk of NODAT persisted in conventional time-varying (HR, 1.32; 95% CI, 1.14 to 1.52; P,0.001) and rolling-average models (HR, 1.34; 95% CI, 1.13 to 1.57; P=0.001). Hypomagnesemia (serum magnesium ,0.74 mmol/L) also significantly associated with increased risk of NODAT in baseline (HR, 1.58; 95% CI, 1.07 to 2.34; P=0.02), time-varying (HR, 1.78; 95% CI, 1.29 to 2.45; P,0.001), and rolling-average models (HR, 1.83; 95% CI, 1.30 to 2.57; P=0.001). Our results suggest that lower post-transplant serum magnesium level is an independent risk factor for NODAT in kidney transplant recipients. Interventions targeting serum magnesium to reduce the risk of NODAT should be evaluated.

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Section: Discussionmentioning

confidence: 98%

“…31,32 In the context of kidney transplantation, however, this association remains controversial due to conflicting findings. [33][34][35][36][37] Moreover, previous studies have methodologic limitations such as not properly accounting for time-varying serum Mg levels over follow-up.…”

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confidence: 99%

Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation

Huang

Famure

et al. 2015

JASN

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“…The use of the calcineurin inhibitors (CNIs), which are widely administered to renal graft recipients as immunosuppressants after renal transplantation, is frequently associated with hypomagnesaemia [ 78 ] . It concerns both cyclosporine and tacrolimus but is more profound in patients on tacrolimus [ 78,79 ] .…”

Section: Hypomagnesaemia In Transplanted Patientsmentioning

confidence: 99%

“…It concerns both cyclosporine and tacrolimus but is more profound in patients on tacrolimus [ 78,79 ] . This side effect is mainly due to a decrease of Mg reabsorption in the distal tubule through the reduction of TRPM6 expression and due to the shifting of magnesium ions from plasma to other tissues [ 80,81 ] .…”

Section: Hypomagnesaemia In Transplanted Patientsmentioning

confidence: 99%

“…The increased renal magnesium loss and the subsequent decrease of serum magnesium occur early, from the fi rst week after the transplantation [ 81 ] , are observed more frequently in diabetic patients [ 82 ] . It has also been found that hypomagnesaemia is an independent predictor of new-onset diabetes after transplantation (NODAT) in renal transplant recipients [ 83,84 ] , although other studies have not con fi rmed it [ 78 ] . Hypomagnesaemia enhances the nephrotoxic action of the CNIs, which in turn increases the renal magnesium loss, leading to a vicious cycle.…”

Section: Hypomagnesaemia In Transplanted Patientsmentioning

confidence: 99%

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Magnesium and Kidney Disease

Tzanakis

Oreopoulos

2012

Magnesium in Human Health and Disease

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An overview of diagnosis and management of drug‐induced hypomagnesemia

Liamis

Hoorn

Florentin

et al. 2021

Pharmacology Res & Perspec

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Hypomagnesemia is usually defined as a serum magnesium (Mg) level below 0.65 mmol/L (1.3 mEq/L; 1.5 mg/dl). 1 Serum Mg exists in three forms: (1) free or ionized Mg, the physiologically active form that accounts for 55%-70% of total serum Mg; (2) Mg complexed to anions, including bicarbonates, sulfates, phosphates, and citrates (5%-15%) and (3) Mg bound to serum proteins (primarily albumin), constituting the remaining approximately 30%. 2 Similarly to hypocalcemia, hypoalbuminemia is also related to spurious hypomagnesemia. 3 Consequently, in hypoalbuminemic states (serum albumin <4 g/dl) corrected serum Mg should be calculated using the formula: corrected Mg (mmol/L) = measured Mg(mmol/L) + 0.005 × (40 − albumin g/L). 4 Correction of Mg for albumin levels is rarely performed in clinical practice, a strategy that should probably change.The incidence of hypomagnesemia varies considerably from merely 2% among individuals in the community up to as high as 65% in patients hospitalized in intensive care units. 5,6 Discrepancies in the reported incidences of hypomagnesemia are attributed to the fact that serum Mg is not routinely measured and that this ion is

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Magnesemia in Renal Transplant Recipients: Relation With Immunosuppression and Posttransplant Diabetes

Cited by 33 publications

References 24 publications

Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation

Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation

Magnesium and Kidney Disease

An overview of diagnosis and management of drug‐induced hypomagnesemia

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