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Zhao Y, Zhao K, Fang J, Wang W. Hemoglobin level and erythropoietin response in hemodialysis patients: what can we pay attention to? Ren Fail 2024; 46:2353338. [PMID: 38738531 PMCID: PMC11095270 DOI: 10.1080/0886022x.2024.2353338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/03/2024] [Indexed: 05/14/2024] Open
Affiliation(s)
- Yu Zhao
- Department of Medicine, Northwest Minzu University, Lanzhou, PR China
- Department of the Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, PR China
| | - Kun Zhao
- Department of the Second Hospital & Clinical Medical School, Lanzhou University, Lanzhou, PR China
| | - Jingchen Fang
- Department of Medicine, Northwest Minzu University, Lanzhou, PR China
| | - Wenyun Wang
- Department of Pediatric Surgery, the Second Hospital of Lanzhou University, Lanzhou, PR China
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Sadeghpour M, Bejani A, Kupaei MH, Majd SJA, Najafi A, Fakhari S, Abdolizadeh A, Mohammadi K. Unraveling the Mechanisms of Magnesium Supplementation in Alleviating Chronic Kidney Disease Complications and Progression: Balancing Risks and Benefits. Biol Trace Elem Res 2024:10.1007/s12011-024-04368-1. [PMID: 39256329 DOI: 10.1007/s12011-024-04368-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 09/03/2024] [Indexed: 09/12/2024]
Abstract
Chronic kidney disease (CKD) is a major cause of death and disability worldwide. It is usually diagnosed at early levels because of its slow progression. Treatment should consider CKD complications (such as electrolyte level imbalance, vascular calcification, and bone mineral disorders), as well as the development of CKD itself. Large-scale studies have shown that current treatment guidelines are nearly ineffective and fail to achieve treatment goals. Guidelines have not paid as much attention to magnesium (Mg) as the other electrolytes, while Mg has a significant role in the treatment goals of CKD. Hypomagnesemia is the only electrolyte imbalance that is equally prevalent in all stages of CKD. A lower plasma Mg level in each stage of CKD is associated with a higher risk of CKD progression and cardiac events. Magnesium exerts its effects both directly and via other ions. Mg supplementation increases insulin sensitivity while reducing proteinuria and inflammation. It lowers blood pressure and inhibits vascular calcification primarily because of its effects on calcium and phosphate, respectively. Vitamin D supplementation for low-active vitamin D in CKD patients increases vascular calcification and cardiac events, but magnesium supplementation enhances vitamin D levels and activity without increasing the risk of cardiac events. However, careful attention is required due to the potential threats of hypermagnesemia, particularly in advanced CKD stages. Starting magnesium supplementation early in patients' treatment plans will result in fewer side effects and more advantages. More original research is needed to determine its optimal dose and serum levels.
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Affiliation(s)
- Majid Sadeghpour
- Department of General Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ali Bejani
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Seyed Jafar Amini Majd
- Department of General Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Afshin Najafi
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Fakhari
- Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Abdolizadeh
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Keivan Mohammadi
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Shahid Chamran Heart Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Kato S, Wang J, Onishi Y, Nangaku M. Association between magnesium, erythropoietin resistance and mortality: the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS). Clin Kidney J 2024; 17:sfae153. [PMID: 38966575 PMCID: PMC11223580 DOI: 10.1093/ckj/sfae153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Indexed: 07/06/2024] Open
Abstract
Background Limited data are now available to evaluate the relationship between serum magnesium level, anemia and mortality in the dialysis population. Methods Using data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 5 and 6, we analyzed the association between serum magnesium (s-Mg) levels and the erythropoiesis-stimulating agents resistance index (ERI) as the primary outcome. To estimate the longitudinal relationship, a mixed-effect model was used with ERI at each 4-month period as the dependent variable and quintiles of s-Mg at the previous 4-month period as the independent variable. We also examined incidence of infectious events, and the all-cause and cardiovascular disease (CVD)-related deaths as secondary outcomes by Cox regression with quintiles of s-Mg at baseline. Results Of the 4776 participants in J-DOPPS, 1650 were included in the analysis. The median of s-Mg at baseline was 2.5 mg/dL. A significant linear association of s-Mg with ERI (P for trend <.001) was revealed. Low and high s-Mg levels were not associated with the clinical outcomes of interest, except for the highest quintile of s-Mg being significantly associated with lower incidence of all-cause mortality and CVD-related deaths compared with the middle (reference) quintile. Conclusions We observed that lower s-Mg levels subsequently induced higher ERI and that mild higher s-Mg levels were possibly associated with good rather than poor outcomes in Japanese hemodialysis patients. Adjustment of s-Mg levels may be proposed as a new strategy at a low cost and risk to reduce the risk of premature mortality.
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Affiliation(s)
- Sawako Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jui Wang
- Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan
- College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yoshihiro Onishi
- Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Li X, Zhu L, Wang Y, Wang Y, Wu B, Gan L, Zuo L. Iron Indices Mediate but Not Modify Association of Parathyroid Hormone with Erythropoietin Resistance in Hemodialysis Patients. Blood Purif 2024; 53:583-590. [PMID: 38710167 DOI: 10.1159/000539080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Disordered iron balance and abnormal parathyroid hormone (PTH) concentrations, both prevalent in hemodialysis patients, are risk factors of erythropoietin (EPO) resistance. Few studies have evaluated the correlation between iron indices and PTH and the potential role of iron markers on the association of PTH with EPO resistance in hemodialysis population. METHODS In this cross-sectional study of 71 maintenance hemodialysis patients, iron indices including hepcidin, ferritin, reticulocyte hemoglobin content (CHr), and transferrin saturation (TSAT) were examined. EPO responsiveness was measured as EPO resistance index (ERI). Lowess regression curves were performed to explore the correlations of iron indices, PTH, and ERI. The association between PTH and ERI was modeled using linear regressions. Potential role of iron indices on this association was examined using stratified analyses and mediation analyses. RESULTS The average ERI value was 10.3 ± 5.3 IU w-1 kg-1 (g/dL) -1. ERI was correlated to PTH, hepcidin, CHr, and TSAT (all p < 0.05). Hepcidin and PTH were closely correlated with each other (r = 0.28, p = 0.020). Analysis by PTH categories yielded a total association effect of 2.53 (95% CI: 0.27-4.85, p = 0.027) for high PTH subgroup versus the reference low subgroup. No clinically significant interaction between iron indexes and PTH was identified. Hepcidin appeared to mediate about one-third of the total association between PTH and ERI in hemodialysis population (33.6%, p = 0.025). CONCLUSION Iron indices and PTH levels were related to ERI values. Hepcidin appeared to be closely correlated to PTH and partly mediate the association between PTH and ERI in hemodialysis population.
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Affiliation(s)
- Xu Li
- Department of Nephrology, Peking University People's Hospital, Beijing, China,
| | - Li Zhu
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Yan Wang
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Yina Wang
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Bei Wu
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Beijing, China
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Kang SH, Kim BY, Son EJ, Kim GO, Do JY. Comparison of Patient Survival According to Erythropoiesis-Stimulating Agent Type of Treatment in Maintenance Hemodialysis Patients. J Clin Med 2023; 12:jcm12020625. [PMID: 36675553 PMCID: PMC9861937 DOI: 10.3390/jcm12020625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
This study aimed to evaluate the difference in patient survival according to the type of erythropoiesis-stimulating agent (ESA) treatment used in the Korean hemodialysis (HD) population. This retrospective study analyzed the laboratory data from a national HD quality assessment program and the claims of Korea. Included participants were divided into three groups according to the type of ESA used during the 6 months of each assessment period as follows: the EP group (n = 38,043, epoetin-α or epoetin-β), the DP group (n = 10,054, darbepoetin-α), and the MR group (2253, continuous erythropoietin receptor activator). The ESA doses in the EP, DP, and MR groups were 6451 ± 3586, 5959 ± 3857, and 3877 ± 2275 unit/week, respectively. The erythropoiesis resistance indexes (ERIs) in the three groups were 10.7 ± 6.7, 9.9 ± 7.6, and 6.3 ± 4.1 IU/kg/g/dL, respectively. Kaplan−Meier curves revealed similar rates of patient survival among the three groups (p = 0.530). A multivariate Cox regression analysis showed that the hazard ratios in the DP group and MR group were 1.00 (p = 0.853) and 0.87 (p < 0.001), respectively, compared to that of the EP group. The hazard ratio in the MR group was 0.87 (p = 0.001) compared to that of the DP group. Our study shows that the MR group had comparable or better patient survival than the EP and DP groups in the multivariate analysis. However, the ESA doses and ERI were considerably different among the three groups. It was difficult to determine whether the better patient survival in the MR group originated from the ESA type, ESA dose, ERI, or other hidden factors.
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Affiliation(s)
- Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
| | - Bo Yeon Kim
- Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea
| | - Eun Jung Son
- Quality Assessment Department, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea
| | - Gui Ok Kim
- Quality Assessment Department, Health Insurance Review and Assessment Service, Wonju 26465, Republic of Korea
| | - Jun Young Do
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea
- Correspondence: ; Tel.: +82-53-620-3836
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Huang J, Xu J, Ye P, Xin X. Association between magnesium intake and the risk of anemia among adults in the United States. Front Nutr 2023; 10:1046749. [PMID: 36908911 PMCID: PMC9996106 DOI: 10.3389/fnut.2023.1046749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Background Magnesium deficiency is related to an increased risk of anemia, but epidemiological evidence supporting this association remains scarce. The purpose of the present survey was to evaluate the relationship between dietary magnesium intake and the risk of anemia. Methods In total, 13,423 participants aged 20-80 years were enrolled using data from the National Health and Nutrition Examination Survey 2011-2016. Magnesium consumption was evaluated using 24 h dietary recalls. Multivariable generalized linear models were developed to demonstrate the association between dietary magnesium intake and the prevalence of anemia. Results An inverse association between dietary magnesium intake and the risk of anemia was detected based on a full adjustment model. We evaluated magnesium intake as a categorical variable (five quartiles). Compared with the lowest value, the highest multivariate adjusted odds ratio (95% confidence interval) for anemia was 0.64 (0.46-0.89). Stratified analyses revealed a reverse relationship between magnesium intake and anemia in women. However, no significant association was observed in men (p for trend = 0.376). A similar reverse association was found among the older group (aged ≥60 years). Conclusion Magnesium deficiency is closely related to a higher rate of anemia occurrence, especially among women and older Americans. Further larger-scale prospective studies are required to confirm these conclusions.
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Affiliation(s)
- Jungao Huang
- Ganzhou Maternal and Child Health Hospital, Ganzhou, Jiangxi, China
| | - Jing Xu
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
| | - Ping Ye
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
| | - Xiaoqin Xin
- Department of Clinical Laboratory, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
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Kaneko S, Ookawara S, Morishita Y. Clinical Factors Associated with Serum Magnesium Concentration in Patients Undergoing Peritoneal Dialysis: A Single-Center Observational Study. Int J Nephrol Renovasc Dis 2022; 15:185-195. [PMID: 35637657 PMCID: PMC9148175 DOI: 10.2147/ijnrd.s357130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Magnesium (Mg) is an essential element that is associated with various physiological functions, such as maintenance of blood pressure, muscle contraction, and nerve function. In patients undergoing hemodialysis, hypomagnesemia is associated with cardiovascular and all-cause mortality. However, in patients undergoing peritoneal dialysis (PD), clinical factors associated with Mg have not been fully investigated. Patients and Methods Clinical factors including anthropometric data, comorbidities, laboratory data, medications, and dialysis methods were collected from the medical records of patients undergoing PD. The associations of these factors with the serum Mg concentration were investigated by univariate and multivariate analyses. Results Sixty patients undergoing PD were investigated. The univariate analysis showed that the serum Mg concentration was significantly associated with treatment by hybrid PD (daily PD + once-weekly hemodialysis) (β = 0.264, P = 0.04), administration of phosphate binders (β = 0.294, P = 0.02), the serum C-reactive protein concentration (β = -0.318, P = 0.01), the serum potassium (K) concentration (β = 0.451, P < 0.01), and the serum intact parathormone concentration (β = -0.333, P = 0.01). The multivariate analysis using these factors showed an independent association between the serum Mg and K concentrations (β = 0.333, P = 0.01). Conclusion The serum Mg concentration was independently associated with the serum K concentration in patients undergoing PD.
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Affiliation(s)
- Shohei Kaneko
- Department of Nephrology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Susumu Ookawara
- Department of Nephrology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yoshiyuki Morishita
- Department of Nephrology, Jichi Medical University Saitama Medical Center, Saitama, Japan
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Ding N, Guo T, Liu SY, Wang QY, Qu XL, Li YF, Ou YN, Yang YY, Sheng ZF. Association between Serum Magnesium and Hemoglobin in Patients with Primary Hyperparathyroidism. Int J Endocrinol 2021; 2021:6049317. [PMID: 34873402 PMCID: PMC8643270 DOI: 10.1155/2021/6049317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/09/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is a positive association between serum magnesium and hemoglobin levels in the general population. However, no studies have evaluated the association between serum magnesium and hemoglobin levels in patients with primary hyperparathyroidism (PHPT). We aimed to investigate whether there is a relationship between serum magnesium and hemoglobin levels in the patient population with PHPT. METHODS This retrospective study included 307 hospitalized PHPT patients who were continuously admitted to the Second Xiangya Hospital of Central South University, from January 2010 to August 2020. Laboratory and demographic data of patients were collected. Hypomagnesemia was defined as serum magnesium <0.75 mmol/L. Patients with a hemoglobin level below 130 g/L in males and below 120 g/L in females were accepted as the anemic group. RESULTS Among the 307 patients with PHPT included in our study, 77 (25.1%) patients (33 (32.4%) males and 44 (21.5%) females) had hypomagnesemia. A total of 138 (45.0%) patients (49 males (48.0%) and 89 females (43.4%)) had anemia. Compared with the nonanemic group, the anemic group had lower average albumin, eGFR, and serum magnesium levels in both males and females. In contrast, average creatinine, PTH, and corrected calcium were significantly higher in the anemic group than in the nonanemic group in both males and females. Lower serum magnesium levels were associated with lower hemoglobin levels independent of serum calcium, albumin, eGFR, and PTH in PHPT patients. CONCLUSIONS Hypomagnesemia is a common electrolyte disorder in PHPT patients. Hypomagnesemia is independently associated with lower hemoglobin levels in patients with PHPT.
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Affiliation(s)
- Na Ding
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
- Blood Transfusion Department, Zhuzhou Central Hospital, Zhuzhou 412007, Hunan, China
| | - Tao Guo
- Department of Surgery, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan, China
| | - Shu-Ying Liu
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Qin-Yi Wang
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiao-Li Qu
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yong-Fang Li
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yang-Na Ou
- Hospital Infection Control Center, The Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan, China
| | - Yan-Yi Yang
- Health Management Center, The Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan, China
| | - Zhi-Feng Sheng
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Health Management Center and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
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Na D, Tao G, Shu-Ying L, Qin-Yi W, Xiao-Li Q, Yong-Fang L, Yang-Na O, Zhi-Feng S, Yan-Yi Y. Association between hypomagnesemia and severity of primary hyperparathyroidism: a retrospective study. BMC Endocr Disord 2021; 21:170. [PMID: 34416890 PMCID: PMC8379767 DOI: 10.1186/s12902-021-00838-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The occurrence of hypomagnesemia in patients with primary hyperparathyroidism (PHPT) has been noted previously; however, the association of hypomagnesemia and severity of primary hyperparathyroidism remains unknown. The present study aimed to evaluate the association of hypomagnesemia with biochemical and clinical manifestations in patients with PHPT. METHODS This was a retrospective study conducted at a tertiary hospital. We obtained data from 307 patients with PHPT from January 2010 through August 2020. Data on demographics, history, laboratory findings, bone densitometry findings, and clinical presentation and complications were collected and were compared in normal magnesium group vs hypomagnesemia group. RESULTS Among the 307 patients with PHPT included in our study, 77 patients (33/102 [32.4%] males and 44/205 [21.5%] females) had hypomagnesemia. Mean hemoglobin levels in the hypomagnesemia group were significantly lower than those in the normal magnesium group in both males and females. In contrast, patients with hypomagnesemia had a higher mean serum calcium and parathyroid hormone than individuals with normal magnesium. The typical symptoms of PHPT, such as nephrolithiasis, bone pain/fractures, polyuria, or polydipsia, were more common in the hypomagnesemia group. In addition, patients with hypomagnesemia had a higher prevalence of osteoporosis, anemia, and hypercalcemic crisis. Even after adjusting for potential confounders, including age, sex, body mass index, estimated glomerular filtration rate, and parathyroid hormone levels, these associations remained essentially unchanged. CONCLUSION Biochemical and clinical evidence indicates that patients with PHPT with hypomagnesemia have more severe hyperparathyroidism than those without hypomagnesemia. In addition, PHPT patients with hypomagnesemia had a higher prevalence of osteoporosis, anemia, and hypercalcemic crisis.
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Affiliation(s)
- Ding Na
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology and Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guo Tao
- Department of Surgery, the First Affiliated Hospital of Hunan Normal University, Changsha, 410005, Hunan, China
| | - Liu Shu-Ying
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology and Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wang Qin-Yi
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology and Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qu Xiao-Li
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology and Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Li Yong-Fang
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology and Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ou Yang-Na
- Hospital Infection Control Center, the Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha, 410011, Hunan, China
| | - Sheng Zhi-Feng
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology and Health Management Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| | - Yang Yan-Yi
- Health Management Center, the Second Xiangya Hospital of Central South University, 139 Middle Renmin Road, Changsha, 410011, Hunan, China.
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A Review of the Action of Magnesium on Several Processes Involved in the Modulation of Hematopoiesis. Int J Mol Sci 2020; 21:ijms21197084. [PMID: 32992944 PMCID: PMC7582682 DOI: 10.3390/ijms21197084] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022] Open
Abstract
Magnesium (Mg2+) is an essential mineral for the functioning and maintenance of the body. Disturbances in Mg2+ intracellular homeostasis result in cell-membrane modification, an increase in oxidative stress, alteration in the proliferation mechanism, differentiation, and apoptosis. Mg2+ deficiency often results in inflammation, with activation of inflammatory pathways and increased production of proinflammatory cytokines by immune cells. Immune cells and others that make up the blood system are from hematopoietic tissue in the bone marrow. The hematopoietic tissue is a tissue with high indices of renovation, and Mg2+ has a pivotal role in the cell replication process, as well as DNA and RNA synthesis. However, the impact of the intra- and extracellular disturbance of Mg2+ homeostasis on the hematopoietic tissue is little explored. This review deals specifically with the physiological requirements of Mg2+ on hematopoiesis, showing various studies related to the physiological requirements and the effects of deficiency or excess of this mineral on the hematopoiesis regulation, as well as on the specific process of erythropoiesis, granulopoiesis, lymphopoiesis, and thrombopoiesis. The literature selected includes studies in vitro, in animal models, and in humans, giving details about the impact that alterations of Mg2+ homeostasis can have on hematopoietic cells and hematopoietic tissue.
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Pérez-García R, Jaldo MT, Puerta M, Ortega M, Corchete E, de Sequera P, Martín-Navarro JA, Albalate M, Alcázar R. La hipomagnesemia en hemodiálisis se asocia a mayor riesgo de mortalidad: su relación con el líquido de diálisis. Nefrologia 2020; 40:552-562. [DOI: 10.1016/j.nefro.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/21/2020] [Accepted: 04/03/2020] [Indexed: 01/19/2023] Open
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Biyik Z, Yavuz YC, Altintepe L. Association between serum magnesium and anemia in patients with chronic kidney disease. Int Urol Nephrol 2020; 52:1935-1941. [PMID: 32514715 DOI: 10.1007/s11255-020-02525-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE An inverse association was shown between serum magnesium levels and anemia in the general population. However, limited information is available about the association between serum magnesium level and anemia in the patient population with chronic kidney disease. We aimed to investigate the relationship between hypomagnesemia and anemia in pre-dialysis patients with chronic kidney disease stage 3-5. METHODS This cross-sectional retrospective study included 213 chronic kidney disease patients with an estimated glomerular filtration rate of 60 mL/min and below. Laboratory and demographic data of outpatients were collected in January 2018-January 2019. Patients with a magnesium level below 1.9 mg/dL were accepted as the hypomagnesemia group. RESULTS Serum magnesium level of 62 (29.1%) of these patients were below 1.9 mg/dL. Compared with normomagnesemic patients, hypomagnesemic patients had lower mean hemoglobin values (11.3 g/dL vs. 12.7 g/dL, P < 0.001), proton-pump inhibitor usage rates were significantly higher (33.9% vs. 17.2%, P = 0.008) and the median urine protein/creatinine ratio was found to be significantly higher (1017.5 mg/gCr vs. 536 mg/gCr, P = 0.045). In the multivariate analysis, the use of hemoglobin (OR 0.634; 95% CI 0.505-0.795; P < 0.001) and proton-pump inhibitor (OR 2.670; 95% CI 1.113-6.318; P = 0.025) were independent predictors of hypomagnesemia. CONCLUSIONS Hypomagnesemia is a common electrolyte disorder in pre-dialysis CKD patients. In this patient group, anemia is independently associated with hypomagnesemia.
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Affiliation(s)
- Zeynep Biyik
- Division of Nephrology, Department of Internal Medicine, Selcuk University Faculty of Medicine, Konya, Turkey.
| | - Yasemin Coskun Yavuz
- Division of Nephrology, Department of Internal Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Lütfullah Altintepe
- Division of Nephrology, Department of Internal Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
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