Abstract: TH-PO139
Association of Serum Magnesium Levels and Calcimimetic Use for Cardiovascular Events (CVE) in Patients on Hemodialysis
Session Information
- CKD-MBD: Clinical
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Saito, Tomohiro, Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Mizobuchi, Masahide, Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Yoshida, Kiryu, Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan
- Kato, Tadashi, Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Kato, Noriyuki, Saiyu Clinic, Saitama, Japan
- Ogata, Hiroaki, Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan
- Koiwa, Fumihiko, Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
- Honda, Hirokazu, Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
Background
Lower serum Mg levels have been shown to be associated with all-cause death and CVE in hemodialysis patients. Calcimimetics use is likely to reduce CVE risk. Serum Mg concentrations are suggested to affect responsiveness of calcimimetics. However, the interaction of caicmimimetics and Mg on CVE remains unclear.
Methods
We conducted a retrospective analysis on 403 HD patients (female, 36.7%; age (median), 62; HD vintage (median), 76 months) in a single facility in Japan. The patients were divided into the user (U; n=196) and the non-user groups (N; n=207), based on status of calcimimetics use at baseline. CVE included cardiovascular death, nonfatal myocardial infarction or stroke, unstable angina, transient ischemic attack, or hospitalization for heart failure or ventricular arrhythmia. Multivariable Cox regression analysis and Kaplan-Meier analysis were applied for analytical approach.
Results
Median observation period was 64 months. CVE significantly occurred in patients in the below-median Mg levels than in those in the above-median Mg levels (Hazard ratio (HR), 0.34 [95% confidence interval, 0.13-0.80]; P = 0.018) among the N group, but the incidence of CVE was comparable among the U group (HR, 1.48 [0.60-3.68]; P = 0.397). A similar trend was observed in all-cause mortality.
Conclusion
These results suggest that low Mg levels may be a predictor of CVE in hemodialysis patients without calcimimectis and the CVE benefits of Mg may be attenuated under the use of calcimimetics.