Kidney Week

Abstract: SA-OR023

The Effect of Increasing Dialysate Magnesium on Serum Calcification Propensity in Subjects with ESRD: A Randomised Double-Blind Controlled Trial

Session Information

• Mineral Disease: Bones, Vessels, Stones
  November 04, 2017 | Location: Room 273, Morial Convention Center
  Abstract Time: 04:54 PM - 05:06 PM

Category: Mineral Disease

• 1205 Vascular Calcification

Authors

• Bressendorff, Iain B., Herlev Hospital, Copenhagen, Denmark

Iain B. Bressendorff, MD

• Hansen, Ditte, Herlev Hospital, Copenhagen, Denmark

Ditte Hansen,

• Schou, Morten, Herlev Hospital, Herlev, Denmark

Morten Schou,

• Pasch, Andreas, University Hospital Bern, Bern, Switzerland

Andreas Pasch,

• Brandi, Lisbet, Nordsjællands Hospital, Hillerød, Denmark

Lisbet Brandi,

Background

Patients undergoing haemodialysis (HD) for end-stage renal disease (ESRD) have an enormously high risk of cardiovascular disease. Serum calcification propensity (T₅₀) is a novel functional test, which quantifies the functionality of the humoral system of calcification control. Low T₅₀ values are associated with increased risk of cardiovascular events and death in patients with ESRD. Increasing magnesium (Mg) in serum increases (i.e. improves) T₅₀ in vitro, but so far no clinical trials have investigated whether increasing serum Mg increases T₅₀ in subjects with ESRD.

Methods

We conducted a single-centre, randomised, double-blinded, controlled clinical trial, in which we examined the effect of increasing dialysate Mg from 0.5 mmol/L to 1.0 mmol/L compared to maintaining dialysate Mg at 0.5 mmol/L on T₅₀ in subjects undergoing HD for ESRD. Fifty-nine subjects underwent 28 days of intervention followed by 14 days of observation.

Results

After increasing dialysate Mg from 0.5 mmol/L to 1.0 mmol/L for 28 days the difference in serum Mg between the two groups was 0.351 mmol/L (between-group difference, 95% confidence interval 0.263 - 0.440, p < 0.001). In parallel to the increase in serum Mg, the difference in T₅₀ between the two groups was 72 min (between-group difference, 95% confidence interval 29 - 114, p < 0.001). One subject withdrew consent (high dialysate Mg group) and two subjects died (one in each treatment group). There were no adverse events considered to be related to the intervention.

Conclusion

Increasing dialysate Mg increased T₅₀ in subjects undergoing maintenance HD. Improving T₅₀ might lead to reductions in cardiovascular events and death in subjects with ESRD.

Funding

• Government Support - Non-U.S.