Association Between Magnesemia and Long-Term Outcome in Peritoneal Dialysis Patients

Ming-Hsin Huang ； Yueh-Ting Lee ； Wei-Hung Kuo ； Ben-Chung Cheng ； Chien-Hsing Wu ； Chien-Te Lee

《Acta Nephrologica》 32卷2期 (2018/06) Pp. 65-72

https://doi.org/10.6221/AN.201806_32(2).0004

摘要

BACKGROUND: Magnesium (Mg) is an abundant cation in human body and essential for life. Dysregulation of Mg homeostasis is well-recognized in patients with chronic kidney disease. Nevertheless, the role of Mg in peritoneal dialysis patients is not clear. The present study was designed to investigate the relationship between serum Mg level and peritoneal clearance, preservation of residual kidney function and mortality in peritoneal dialysis patients. METHOD: A total of 213 prevalent peritoneal dialysis patients were included for analysis. Their demographic and biochemical data and peritoneal function were reviewed and collected. Patients were divided into two groups according to their serum Mg level (low Mg: ≤ 1.6 mEq/L; high Mg: ＞ 1.6 mEg/ L). Factors associated time-averaged serum Mg level were identified. The prognostic role of Mg and long-term outcome was analyzed in an averaged follow-up period of 51 months. RESULTS: Patients with low Mg levels had lower normalized protein catabolic rate (nPCR, 0.97 vs. 1.02 gm/kg body weight [BW]/day, P = 0.049), albumin (3.7 vs. 3.8 g/dL, P = 0.020), phosphate (5.1 vs. 5.5 mg/ dL, P = 0.020), potassium (3.9 vs. 4.1 mEq/L, P = 0.020), and higher high-sensitivity C-reactive protein (hs- CRP, 8.1 vs. 6.0 mg/L, P = 0.049). Multivariate regression analysis revealed nPCR, albumin, and phosphate were independent factors related to serum Mg level. Compared to high Mg group, low Mg group had lower survival rate (89% vs. 96%, P = 0.043), lower free atherosclerotic cardiovascular events (74% vs. 86%, P = 0.042), and lower rate of preservation of residual kidney function (31% vs. 50%, P = 0.030). CONCLUSION: Time-averaged Mg was associated with nPCR, serum albumin and phosphate. Patients with low Mg levels had increased loss of residual kidney function, atherosclerotic cardiovascular events and mortality.

關鍵字

peritoneal dialysis ； magnesium ； residual kidney function ； mortality ； peritonitis