Dietary magnesium supplementation in cats with chronic kidney disease: A prospective double-blind randomized controlled trial

IF 2.1 2区 农林科学 Q1 VETERINARY SCIENCES
Pak-Kan Tang, Dirk Hendrik Nicolaas van den Broek, Rosanne E. Jepson, Rebecca F. Geddes, Yu-Mei Chang, Nicola Lötter, Delphine Moniot, Vincent Biourge, Jonathan Elliott
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Abstract

Background

Plasma total magnesium concentration (tMg) is a prognostic indicator in cats with chronic kidney disease (CKD), shorter survival time being associated with hypomagnesemia. Whether this risk factor is modifiable with dietary magnesium supplementation remains unexplored.

Objectives

Evaluate effects of a magnesium-enriched phosphate-restricted diet (PRD) on CKD–mineral bone disorder (CKD-MBD) variables.

Animals

Sixty euthyroid client-owned cats with azotemic CKD, with 27 and 33 allocated to magnesium-enriched PRD or control PRD, respectively.

Methods

Prospective double-blind, parallel-group randomized trial. Cats with CKD, stabilized on a PRD, without hypermagnesemia (tMg >2.43 mg/dL) or hypercalcemia (plasma ionized calcium concentration, (iCa) >6 mg/dL), were recruited. Both intention-to-treat and per-protocol (eating ≥50% of study diet) analyses were performed; effects of dietary magnesium supplementation on clinicopathological variables were evaluated using linear mixed effects models.

Results

In the per-protocol analysis, tMg increased in cats consuming a magnesium-enriched PRD (β, 0.25 ± .07 mg/dL/month; P < .001). Five magnesium supplemented cats had tMg >2.92 mg/dL, but none experienced adverse effects. Rate of change in iCa differed between groups (P = .01), with decreasing and increasing trends observed in cats fed magnesium-enriched PRD and control PRD, respectively. Four control cats developed ionized hypercalcemia versus none in the magnesium supplemented group. Log-transformed plasma fibroblast growth factor-23 concentration (FGF23) increased significantly in controls (β, 0.14 ± .05 pg/mL/month; P = .01), but remained stable in the magnesium supplemented group (β, 0.05±.06 pg/mL/month; P =.37).

Conclusions and Clinical Importance

Magnesium-enriched PRD is a novel therapeutic strategy for managing feline CKD-MBD in cats, further stabilizing plasma FGF23 and preventing hypercalcemia.

Abstract Image

慢性肾病猫的镁膳食补充剂:前瞻性双盲随机对照试验。
背景:血浆总镁浓度(tMg)是慢性肾脏病(CKD)猫的预后指标,低镁血症会缩短存活时间。这一风险因素是否可通过饮食中补充镁来改变,目前仍未得到研究:评估富含镁的限磷饮食(PRD)对 CKD-矿物质骨骼紊乱(CKD-MBD)变量的影响:60只患有氮质血症CKD的甲状腺功能正常的客户饲养的猫,其中27只和33只分别被分配到富含镁的PRD或对照PRD中:前瞻性双盲平行组随机试验。方法:前瞻性双盲平行组随机试验招募了患有慢性肾脏病、服用 PRD 后病情稳定、无高镁血症(tMg >2.43 mg/dL)或高钙血症(血浆离子化钙浓度 (iCa) >6 mg/dL)的猫。进行了意向治疗分析和按协议(饮食≥研究饮食的50%)分析;使用线性混合效应模型评估了饮食补镁对临床病理变量的影响:在按协议分析中,摄入富镁 PRD 的猫 tMg 增加(β,0.25 ± .07 mg/dL/月;P 2.92 mg/dL),但没有猫出现不良反应。不同组 iCa 的变化率不同(P = .01),喂食富镁 PRD 和对照组 PRD 的猫分别呈下降和上升趋势。四只对照组猫咪出现了离子化高钙血症,而补镁组猫咪则没有。对数转换血浆成纤维细胞生长因子-23浓度(FGF23)在对照组中显著增加(β,0.14 ± .05 pg/mL/月;P = .01),但在补镁组中保持稳定(β,0.05±.06 pg/mL/月;P =.37):结论和临床意义:富含镁的 PRD 是治疗猫 CKD-MBD 的一种新型治疗策略,可进一步稳定血浆 FGF23 并预防高钙血症。
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来源期刊
CiteScore
4.50
自引率
11.50%
发文量
243
审稿时长
22 weeks
期刊介绍: The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.
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