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To evaluate the relationship between serum magnesium and parathyroid hormone levels in peritoneal dialysis and hemodialysis patients

  • Nephrology - Original Paper
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Abstract

Objects

This study aimed to determine the relationship between magnesium and PTH levels in peritoneal dialysis (PD) and hemodialysis (HD) patients.

Methods

This cross-sectional study was performed on HD and PD patients in Kerman, Iran. After recording demographic and clinical data, the pre-dialysis levels of hemoglobin, 25-hydroxy vitamin D, ferritin, creatinine, calcium, phosphorus, albumin, PTH, and magnesium were measured for all patients. The P value of less than 0.05 was considered statistically significant.

Results

Magnesium levels in PD patients were significantly higher than in HD patients (P < 0.001). The median PTH level in PD patients was significantly lower than in HD patients (P = 0.046). The correlation between PTH and serum magnesium levels was not significant in PD or HD patients. In the regression model, dialysis modality (PD or HD) was the only significant variable in determining serum magnesium levels (P = 0.005).

Conclusion

Magnesium is a neglected ion in peritoneal dialysis and hemodialysis patients. In dialysis centers that use a dialysate with standard magnesium concentration (0.5 mmol/L in HD and 0.75 mmol/L in PD), special attention is necessary to hypomagnesia and its complications because magnesium levels in PD patients were significantly higher than in HD patients. As the correlation between magnesium and PTH levels in both PD and HD patients were not significant, the association of high magnesium levels with low PTH in PD patients should be considered in terms of increasing the potential for adynamic bone disease. It seems that ordering serum magnesium in the routine tests of dialysis patients is necessary.

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Data availability

The data supporting this study’s findings are available from the corresponding author upon reasonable request.

References

  1. Lv JC, Zhang LX (2019) Prevalence and disease burden of chronic kidney disease. Adv Exp Med Biol 1165:3–15

    Article  CAS  PubMed  Google Scholar 

  2. De Boer IH, Gorodetskaya I, Young B, Hsu CY, Chertow GM (2002) The severity of secondary hyperparathyroidism in chronic renal insufficiency is GFR-dependent, race-dependent, and associated with cardiovascular disease. J Am Soc Nephrol 13(11):2762–2769

    Article  PubMed  Google Scholar 

  3. Tsai S, Zhao H, Wu B, Zuo L, Wang M (2018) Serum magnesium abnormality and influencing factors of serum magnesium level in peritoneal dialysis patients: a single-center study in northern China. Blood Purif 45(1–3):110–117

    Article  CAS  PubMed  Google Scholar 

  4. Rodríguez-Ortiz ME, Canalejo A, Herencia C, Martínez-Moreno JM, Peralta-Ramírez A, Perez-Martinez P et al (2014) Magnesium modulates parathyroid hormone secretion and upregulates parathyroid receptor expression at moderately low calcium concentration. Nephrol Dial Transplant 29(2):282–289

    Article  PubMed  Google Scholar 

  5. Mountokalakis TD (1990) Magnesium metabolism in chronic renal failure. Magnes Res 3(2):121–127

    CAS  PubMed  Google Scholar 

  6. Lindeman RD (1986) Chronic renal failure and magnesium metabolism. Magnesium 5(5–6):293–300

    CAS  PubMed  Google Scholar 

  7. Ye H, Cao P, Zhang X, Lin J, Guo Q, Mao H et al (2018) Serum magnesium and cardiovascular mortality in peritoneal dialysis patients: a 5-year prospective cohort study. Br J Nutr 120(4):415–423

    Article  CAS  PubMed  Google Scholar 

  8. Molnar AO, Biyani M, Hammond I, Harmon JP, Lavoie S, McCormick B et al (2017) Lower serum magnesium is associated with vascular calcification in peritoneal dialysis patients: a cross sectional study. BMC Nephrol 18(1):129

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kroll MH, Elin RJ (1985) Relationships between magnesium and protein concentrations in serum. Clin Chem 31(2):244–246

    Article  CAS  PubMed  Google Scholar 

  10. Abedi-Samakoosh M, Ahangarkani F, Aghaie N, Gholami F, Shirzad M, Naseripour Z (2018) The relationship between the adequacy of hemodialysis and laboratory parameters. Chronic Dis J 5(1):19–27

    Google Scholar 

  11. Yari Z, Tabibi H, Najafi I, Hedayati M, Movahedian M (2020) Effects of soy isoflavones on serum systemic and vascular inflammation markers and oxidative stress in peritoneal dialysis patients: a randomized controlled trial. Phytother Res PTR 34(11):3011–3018

    Article  CAS  PubMed  Google Scholar 

  12. Navarro JF, Mora C, Jiménez A, Torres A, Macía M, García J (1999) Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients. Am J Kidney Dis 34(1):43–48

    Article  CAS  PubMed  Google Scholar 

  13. Navarro JF, Mora C, Macia M, Garcia J (1999) Serum magnesium concentration is an independent predictor of parathyroid hormone levels in peritoneal dialysis patients. Perit Dial Int 19(5):455–461

    Article  CAS  PubMed  Google Scholar 

  14. Han Z, Zhou L, Liu R, Feng L (2020) The effect of hemodialysis on serum magnesium concentration in hemodialysis patients. Ann Palliat Med 9(3):1134–1143

    Article  PubMed  Google Scholar 

  15. Ohya M, Negi S, Sakaguchi T, Koiwa F, Ando R, Komatsu Y et al (2014) Significance of serum magnesium as an independent correlative factor on the parathyroid hormone level in uremic patients. J Clin Endocrinol Metab 99(10):3873–3878

    Article  CAS  PubMed  Google Scholar 

  16. Fatuzzo P, Portale G, Scollo V, Zanoli L, Granata A (2017) Proton pump inhibitors and symptomatic hypomagnesemic hypoparathyroidism. J Nephrol 30(2):297–301

    Article  CAS  PubMed  Google Scholar 

  17. Van Laecke S (2019) Hypomagnesemia and hypermagnesemia. Acta Clin Belg 74(1):41–47

    Article  PubMed  Google Scholar 

  18. Mizobuchi M, Ogata H, Koiwa F (2019) Secondary hyperparathyroidism: pathogenesis and latest treatment. Ther Apher Dial 23(4):309–318

    Article  PubMed  Google Scholar 

  19. Cunningham J, Rodríguez M, Messa P (2012) Magnesium in chronic kidney disease Stages 3 and 4 and in dialysis patients. Clin Kidney J 5(Suppl 1):i39–i51

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Bressendorff I, Hansen D, Schou M, Pasch A, Brandi L (2018) The effect of increasing dialysate magnesium on serum calcification propensity in subjects with end stage kidney disease: a randomized, controlled clinical trial. Clin J American Soc Nephrol CJASN 13(9):1373–1380

    Article  CAS  Google Scholar 

  21. Wei M, Esbaei K, Bargman JM, Oreopoulos DG (2006) Inverse correlation between serum magnesium and parathyroid hormone in peritoneal dialysis patients: a contributing factor to adynamic bone disease? Int Urol Nephrol 38(2):317–322

    Article  CAS  PubMed  Google Scholar 

  22. De Vecchi A, Finazzi S, Padalino R, Santagostino T, Bottaro E, Roma E et al (2000) Sleep disorders in peritoneal and haemodialysis patients as assessed by a self-administered questionnaire. Int J Artif Organs 23(4):237–242

    Article  PubMed  Google Scholar 

  23. Merlino G, Lorenzut S, Romano G, Sommaro M, Fontana A, Montanaro D et al (2012) Restless legs syndrome in dialysis patients: a comparison between hemodialysis and continuous ambulatory peritoneal dialysis. Neurol Sci 33(6):1311–1318

    Article  PubMed  Google Scholar 

  24. Huang JH, Cheng FC, Wu HC (2015) Low magnesium exacerbates osteoporosis in chronic kidney disease patients with diabetes. Int J Endocrinol 2015:380247

    Article  PubMed  PubMed Central  Google Scholar 

  25. Elokely AM, GhareebMenshawy A, Hosny Zahran M (2020) Correlation between serum magnesium and parathyroid hormone in hemodialysis patients. Benha Med J 37(Special issue (Internal medicine and Hepatology)):91–98

    Google Scholar 

  26. Fooladgar M, Malekpour A, Asgari-Savadjani S, Mardani S (2018) Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients. J Parathyr Dis 6(1):13–15

    Article  Google Scholar 

  27. Shieh A, Ma C, Chun RF, Wittwer-Schegg J, Swinkels L, Huijs T et al (2018) Associations between change in total and free 25-hydroxyvitamin d with 24,25-dihydroxyvitamin d and parathyroid hormone. J Clin Endocrinol Metab 103(9):3368–3375

    Article  PubMed  PubMed Central  Google Scholar 

  28. Brandenburg VM, Floege J (2008) Adynamic bone disease-bone and beyond. NDT Plus 1(3):135–147

    PubMed  PubMed Central  Google Scholar 

  29. Heaf J (2001) Causes and consequences of adynamic bone disease. Nephron 88(2):97–106

    Article  CAS  PubMed  Google Scholar 

  30. Heaf JG (2015) Chronic kidney disease-mineral bone disorder in the elderly peritoneal dialysis patient. Perit Dial Int 35(6):640–644

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Moe SM (2004) Management of renal osteodystrophy in peritoneal dialysis patients. Peritoneal Dial Int 24(3):209–216

    Article  Google Scholar 

Download references

Acknowledgements

We, the authors, thank the staff and patients of the Kerman University of Medical Sciences dialysis wards. Special thanks to MS Azam Dehghani for cooperating in entering the data in SPSS.

Funding

The Kerman University of Medical Sciences funded this study. The data in this article were taken from the General Medicine thesis of Malihe Molahoseini at the Kerman University of Medical Sciences. (Reg. No. 98000275).

Author information

Authors and Affiliations

  1. Student Research Committee and Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

    Najmeh Shamspour

  2. Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran

    Malihe Molahoseini

  3. Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

    Jalal Azmandian

  4. Department of Community Medicine, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

    Habibeh Ahmadipour

  5. Resident of Internal Medicine, Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, 7616913555, Iran

    Amir Baniasad

Authors
  1. Najmeh Shamspour
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  2. Malihe Molahoseini
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  3. Jalal Azmandian
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  4. Habibeh Ahmadipour
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  5. Amir Baniasad
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Corresponding author

Correspondence to Amir Baniasad.

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Conflict of interest

There is no conflict of interest to declare.

Ethical approval

Data collection forms were anonymous and fiduciary, confidential, and non-disclosure of participants’ secrets. Ethical consent was obtained from all patients. This research with the ethical code IR.KMU.AH.REC.1398.133 was approved by the ethics committee of Kerman University of Medical Sciences.

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Shamspour, N., Molahoseini, M., Azmandian, J. et al. To evaluate the relationship between serum magnesium and parathyroid hormone levels in peritoneal dialysis and hemodialysis patients. Int Urol Nephrol 55, 1321–1327 (2023). https://doi.org/10.1007/s11255-022-03445-5

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  • DOI: https://doi.org/10.1007/s11255-022-03445-5

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