Kanbay et. al. [65] |
2012 |
Observational cohort study. |
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51 years.
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Stage 3: (29–71 years, Male/Female: 48/53).
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Stage 4: (31–73 years, Male/Female: 46/40).
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Stage 5: (28–71 years, Male/Female: 45/51).
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283 patients (101 in stage 3, 86 in stage 4, and 96 in stage 5). Of the Renal Unit of the Gulhane School of Medicine Medical Center, Ankara, Turkey
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Strong positive correlation between flow-mediated dilation and Mg values.
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A higher Mg level is associated with less endothelial dysfunction (p < 0.001).
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A higher level of Mg may protect against endothelial damage and is associated with better survival.
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Wyskida et. al. [66] |
2012 |
Prospective, open-label, cross-sectional clinical study. |
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|
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Hemodialysis three times per week for 4 to 5 h (12.7 ± 1.1 h weekly).
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Carbohydrate dialysate fluid containing: 0.75 mmol/L of Mg and polysulfone or cuprofane dialysis membranes was used.
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Control group: mean serum Mg concentration was 0.89 ± 0.06 mmol/L.
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The average serum Mg concentration before hemodialysis was 1.32 ± 0.18 mmol/L, which was 48% higher than in the control group.
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Hypermagnesemia (≥1.5 mmol/L) was found in 81.2% of hemodialysis patients.
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With a higher prevalence in males (odds ratio = 1.98 [0.64 to 6.13], p = 23).
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Strong positive correlation between daily intake of Mg and its serum concentration in hemodialysis patients (r = 0.870, p < 0.001).
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Van Laecke et. al. [67] |
2013 |
Retrospective cohort study. |
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57.4 ± 17.3 years
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56.1% were male.
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|
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eGFR was calculated using the abbreviated MDRD (Modification of Diet in Renal Disease).
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Mg was analyzed as a continuous, based on the lower and upper normal limits of the laboratory (3 groups: <1.8 mg/dL, 1.8–2.2 mg/dL, and >2.2 mg/dL).
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Low serum Mg levels predict higher mortality in CKD, independent of the initial degree of renal impairment.
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Mg concentrations were related to the rate of kidney function decline after adjustment for age, sex, diabetes, and hypertension.
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Low serum Mg predicts a faster decline in kidney function.
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Sakaguchi et. al. [58] |
2013 |
Observational cohort study |
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Lower serum Mg level was a significant and independent predictor of cardiovascular mortality among the chronic hemodialysis population.
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Lower Mg level was significantly associated with older age, lower albumin, calcium, phosphate, and hemoglobin level, higher C-reactive protein and alkaline phosphate level, increased prevalence of diabetes mellitus, prior history of cardiovascular disease, and hip fracture.
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Lacson et. al. [68] |
2015 |
Observational retrospective cohort study. |
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61.7 ± 14.8 years.
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11, 650 (54.1%) were male.
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Follow-up analysis: 61.8 ± 14.8 years and 14,799 (53.7%) were male.
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21,534 patients of Fresenius Medical Care North America outpatient dialysis facilities.
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Follow-up analysis: n = 27,544 patients.
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Hypomagnesemia: Mg < 1.30 mEq/L; low, mid, and high-normal Mg levels: 1.30 to < 1.60, 1.60 to < 1.90, and 1.90 to 2.10 mEq/L, respectively.
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Hypermagnesemia: >2.10 mEq/L.
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The mid-normal range (1.60 to <1.90 mEq/L) was used as the reference group.
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The mean serum Mg level was higher overall that the prescribed dialysate mg concentration, with a positive correlation (PC: R = 0.22; p < 0.001).
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Increasing serum Mg levels were associated with decreasing 1-year mortality risk.
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Patients with serum Mg levels > 2.10 mEq/L had a survival advantage (HR, 0.89; 95% CI, 0.80–0.95).
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Rebholz et. al. [69] |
2016 |
Prospective cohort study. |
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47 years.
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41% were male.
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Dietary Mg intake was 116 (96–356) mg/1000 kcal.
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The mean baseline eGFR in the overall study population was 97 mL/min/1.73 m2.
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eGFR was calculated using the CKD- EPI equation.
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Increased probability of rapid deterioration of renal function in association with low dietary intake of Mg (eGFR 100 vs. 94 mL/min /1.73 m2; p < 0.001).
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Dietary intake of Mg was associated with rapid kidney function decline independent of multiple kidney disease risk factors.
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Ferrè et. al. [70] |
2017 |
A multiethnic, population-based, cohort study. |
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30–65 years.
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47.2% were male.
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Serum Mg was normally distributed with a mean ± SD value of 2.07 ± 18 mg/dL (0.85 ± 0.07 mM) in the entire cohort, and 2.08 ± 0.19 mg/dL (0.85 ± 0.08 mM) in the CKD and 2.07 ± 0.18 mg/dL (0.85 ± 0.07) in the non-CKD subgroups.
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eGFR was calculated using the CKD- EPI equation and the MDRD.
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Low serum Mg levels are independently associated with a higher risk of all-cause death in patients with prevalent early-stage CKD.
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And is a significant predictor of death in pre-dialysis CKD patients or patients undergoing hemodialysis.
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Farhadnejad et. al. [71] |
2016 |
Prospective population-based cohort study. |
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43.3 ± 11.4 years.
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49.2% were men.
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|
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CKD was defined as eGFR < 60 mL/min//1.73 m2.
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eGFR was calculated using the abbreviated MDRD (Modification of Diet in Renal Disease).
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Dietary intakes were collected using a food frequency questionnaire.
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Higher intakes of Mg (OR: 0.41, 95% CI: 0.22–0.76) were significantly associated with a lower risk of CKD.
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The protective effect of Mg (estimated average requirement: 581 mg) decreases the risk of CKD by 60%.
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Azem et. al. [63] |
2020 |
Observational cohort study. |
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68.7 ± 13.3 years.
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47% were men.
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|
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The mean eGFR of the study population was 46.3 mL/min/1.73 m2.
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eGFR was calculated using the CKD- EPI equation.
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Serum Mg was classified based on the normal range into the following categories: <1.7, 1.7–2.6, and >2.6 mg/dL.
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Mg data obtained within one year prior to the second e
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GFR < 60 mL/min/1.73 m2 was included.
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U-shaped association between serum Mg levels and mortality, with both hypomagnesemia and hypermagnesemia (HR = 1.23, 95% CI: 1.03, 1.48).
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No association between serum Mg levels and the rate of eGFR decline in CKD patients.
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Galán Carrillo et. al. [64] |
2021 |
Retrospective observational cohort study. |
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70 ± 13 years.
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62.9% were male.
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Between December 2010 and December 2012.
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Followed up to December 2016.
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Were followed for a mean of 42.6 months.
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The use of calcitriol (p = 0.029) was associated with higher serum Mg concentration, while calcium supplements (p = 0.038) and proton pump (p = 0.026) inhibitors were associated with lower serum Mg concentration.
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Loop diuretics demonstrated a statistically significant positive association with serum Mg (p < 0.001).
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No association was found between serum Mg concentration and initiation of kidney replacement therapy.
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Patients with hypermagnesemia (Mg > 2.2 mg/dL) had a higher risk of cardiovascular events (p = 0.028).
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