Low magnesium levels linked to ESRD risk in diabetes
MedWire News: Hypomagnesemia is significantly associated with progression to end-stage renal disease (ESRD) in patients with Type 2 diabetic nephropathy, show study findings.
Patients with diabetic nephropathy who had low magnesium (Mg) levels were at more than twice the risk for progressing to ESRD than those who had high Mg levels, report Yusuke Sakaguchi (Osaka General Medical Center, Japan) and colleagues.
As reported in Diabetes Care, the team analyzed the medical records for 445 hospitalized patients with chronic kidney disease ([CKD] estimated glomerular filtration rate <60 mL/min per 1.73 m2) who participated in a 1-week CKD education program between April 2001 and December 2007. The patients' Mg levels were assessed soon after admission and they were followed-up for progression to ESRD (defined as the initiation of renal replacement therapy) from the day of hospitalization through 1 April 2011.
The researchers categorized the patients as having either high or low serum Mg levels with a cutoff value of 1.8 mg/dL and compared the impact of hypomagnesemia on renal outcome in those with Type 2 diabetic nephropathy (n=144) and those with nondiabetic CKD (n=311).
The team reports that, of the individuals with diabetic nephropathy, 102 progressed to ESRD during a median follow-up period of 23 months, while 135 nondiabetic CKD patients progressed to ESRD over a median of 44 months.
Cox proportional hazards modeling showed that, among the patients with diabetic nephropathy, those in the low-Mg group were at a 2.12-fold higher risk for developing ESRD than those in the high-Mg group. In contrast, there was no significant difference in ESRD risk between the low- and high-Mg groups among those with nondiaebtic CKD.
The researchers say their findings showed that hypomagnesemia in patients with Type 2 diabetic nephropathy is a novel independent predictor for ESRD.
However, "it is unclear why the impact of hypomagnesemia on renal outcome differed between Type 2 diabetic nephropathy and nondiabetic CKD," write Sakaguchi et al. "The precise pathogenesis of Mg deficiency in Type 2 diabetic nephropathy should be further investigated."
The researchers also point out that an important clinical implication of their findings is that Mg supplementation may be renoprotective in Type 2 diabetic nephropathy.
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By Sally Robertson