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Abstract: FR-PO915

Association of Serum Magnesium Concentration with Renal Prognosis in Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Kishi, Seiji, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Takaya, Nakashima, Nagasaki Daigaku, Nagasaki, Nagasaki, Japan
  • Goto, Tadahiro, TXP Medical, Tokyo, Japan
  • Nagasu, Hajime, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
Background

Magnesium plays a crucial role in various physiological processes, and disruptions in its balance have been linked to adverse health effects. By investigating the impact of magnesium levels on renal outcomes, this study aims to contribute to our understanding of managing magnesium levels in CKD patients. The findings may provide valuable insights for clinical practice and future intervention studies in this population.

Methods

This study utilized the J-CKD-DB-Ex database, comprising CKD patients enrolled between 2014 and 2020. Only patients with at least two measurements of magnesium and eGFR were included. The index date was established as the time of the initial magnesium measurement, and individuals with an eGFR greater than 15 and less than 60 ml/min/1.73 m2 at the index date were selected. The study categorized participants into three groups based on their magnesium levels: low, normal, and high magnesium. Patients who had a single clinic visit or a history of hospitalization were excluded from the analysis. The primary outcome was defined as the progression to ESKD, determined by an eGFR below 15 mL/min/1.73m2 or a decline of 30% or more in eGFR from baseline.

Results

A cohort of 9,996 patients without prior hospitalization was analyzed. Hypomagnesemia was present in 6% of patients, while hypermagnesemia was observed in 4% of patients. Initial Kaplan-Meier survival curve analysis, without adjustment, showed a significantly worse renal prognosis in the hypomagnesemia group. However, to address potential confounding factors, multiple imputation and Cox regression analysis were conducted, with the normal magnesium group as the reference. After adjusting for covariates, the hypomagnesemia group had a hazard ratio of 1.26 (95% confidence interval: 1.08-1.46), indicating an increased risk of adverse renal outcomes compared to the normal magnesium group. Adjusted restricted cubic spline analysis also supported this trend, demonstrating that lower magnesium levels were associated with poorer renal prognosis.

Conclusion

The study findings suggest that the renal prognosis of patients is influenced by their serum magnesium concentration, with poorer outcomes observed in individuals with hypomagnesemia.

Funding

  • Private Foundation Support