Abstract
Background
Magnesium deficiency is associated with various health conditions, but its impact on the progression of chronic kidney disease (CKD) remains unclear. This study aimed to investigate the association between serum magnesium levels and prognosis of renal function in CKD patients.
Methods
This is an analysis of the Japan Chronic Kidney Disease Database Ex (J-CKD-DB-Ex), which is a multicenter prospective cohort including CKD patients enrolled from January 1, 2014 to December 31, 2020. We included adult outpatients with CKD stage G3 and G4 at the time of initial magnesium measurement. Patients were classified by magnesium levels as low (<1.7 mg/dl), normal (1.7–2.6 mg/dl), or high (>2.6 mg/dl). The primary outcomes were the composite of an eGFR < 15 ml/min/1.73 m2 or a ≥30% reduction in eGFR from the initial measurement, which was defined as CKD progression. We applied the Kaplan–Meier analysis and Cox regression hazard model to examine the association between magnesium levels and CKD progression.
Results
The analysis included 9868 outpatients during the follow-up period. The low magnesium group was significantly more likely to reach CKD progression. Cox regression, adjusting for covariates and using the normal magnesium group as the reference, showed that the hazard ratio for the low magnesium group was 1.20 (1.08–1.34). High magnesium was not significantly associated with poor renal outcomes compared with normal magnesium.
Conclusion
Based on large real-world data, this study demonstrated that low magnesium levels are associated with poorer renal outcomes.
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Data availability
J-CKD-DB-Ex, which was analyzed in this study, is a real-world database established under the initiative of the Japanese Society of Nephrology. For data analysis, the steering committee will review the submitted research plan. Data sharing is not possible at this time, as we plan to proceed with the analysis by providing the necessary data to the research plans that are approved after the review.
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Acknowledgements
We would like to thank Kaori Ikemoto, Department of Nephrology and Hypertension, for her assistance in data management.
Funding
This work was supported by grants from Research Project Grant from Kawasaki Medical School (R05B111) to SK and Japan Agency for Medical Research and Development, Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus to N.K. (22ek0210135h0001).
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SK, TN, and TG, contributed to the study conception and design, analysis and interpretation of data, wrote the first draft of the manuscript, and final approval of the submitted manuscript. CRB contributed to the interpretation of the data, scientific and grammatical editing of the English text, and final approval of the submitted manuscript. HN and NK contributed to study conception and design, interpretation of data, and final approval of the submitted manuscript. HO, KT, TN, IN, SM, YY, TY, TW, JW, and MN contributed to the interpretation of data and final approval of the submitted manuscript.
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Kishi, S., Nakashima, T., Goto, T. et al. Association of serum magnesium levels with renal prognosis in patients with chronic kidney disease. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02486-7
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DOI: https://doi.org/10.1007/s10157-024-02486-7