Association of serum magnesium levels with renal prognosis in patients with chronic kidney disease.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY

Clinical and Experimental Nephrology Pub Date : 2024-08-01 Epub Date: 2024-03-20 DOI:10.1007/s10157-024-02486-7

Seiji Kishi, Takaya Nakashima, Tadahiro Goto, Hajime Nagasu, Craig R Brooks, Hirokazu Okada, Kouichi Tamura, Toshiaki Nakano, Ichiei Narita, Shoichi Maruyama, Yuichiro Yano, Takashi Yokoo, Takashi Wada, Jun Wada, Masaomi Nangaku, Naoki Kashihara

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引用次数: 0

Abstract

Background: Magnesium deficiency is associated with various health conditions, but its impact on the progression of chronic kidney disease (CKD) remains unclear. This study aimed to investigate the association between serum magnesium levels and prognosis of renal function in CKD patients.

Methods: This is an analysis of the Japan Chronic Kidney Disease Database Ex　(J-CKD-DB-Ex), which is a multicenter prospective cohort including CKD patients enrolled from January 1, 2014 to December 31, 2020. We included adult outpatients with CKD stage G3 and G4 at the time of initial magnesium measurement. Patients were classified by magnesium levels as low (<1.7 mg/dl), normal (1.7-2.6 mg/dl), or high (>2.6 mg/dl). The primary outcomes were the composite of an eGFR < 15 ml/min/1.73 m² or a ≥30% reduction in eGFR from the initial measurement, which was defined as CKD progression. We applied the Kaplan-Meier analysis and Cox regression hazard model to examine the association between magnesium levels and CKD progression.

Results: The analysis included 9868 outpatients during the follow-up period. The low magnesium group was significantly more likely to reach CKD progression. Cox regression, adjusting for covariates and using the normal magnesium group as the reference, showed that the hazard ratio for the low magnesium group was 1.20 (1.08-1.34). High magnesium was not significantly associated with poor renal outcomes compared with normal magnesium.

Conclusion: Based on large real-world data, this study demonstrated that low magnesium levels are associated with poorer renal outcomes.

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慢性肾脏病患者血清镁水平与肾脏预后的关系。

背景：镁缺乏与多种健康状况有关，但其对慢性肾脏病（CKD）进展的影响仍不明确。本研究旨在探讨 CKD 患者血清镁水平与肾功能预后之间的关系：本研究对日本慢性肾脏病数据库（Japan Chronic Kidney Disease Database Ex，J-CKD-DB-Ex）进行了分析，该数据库是一个多中心前瞻性队列，包括从 2014 年 1 月 1 日至 2020 年 12 月 31 日登记的 CKD 患者。我们纳入了首次测量镁时处于 CKD G3 和 G4 阶段的成人门诊患者。患者的镁水平被划分为低水平（2.6 mg/dl）。主要结果是 eGFR 为 2 或 eGFR 比首次测量值下降≥30% 的复合结果，后者被定义为 CKD 进展。我们采用卡普兰-梅耶分析和 Cox 回归危险模型来研究镁水平与 CKD 进展之间的关系：分析纳入了随访期间的 9868 名门诊患者。低镁组患 CKD 的几率明显更高。调整协变量并以正常镁组为参照的 Cox 回归显示，低镁组的危险比为 1.20（1.08-1.34）。与正常血镁相比，高血镁与不良肾脏预后无明显相关性：基于大量真实世界的数据，本研究表明，低血镁水平与较差的肾脏预后有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.