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

Category: Mineral Disease

  • 1205 Vascular Calcification

Authors

  • Bressendorff, Iain B., Herlev Hospital, Copenhagen, Denmark
  • Hansen, Ditte, Herlev Hospital, Copenhagen, Denmark
  • Schou, Morten, Herlev Hospital, Herlev, Denmark
  • Pasch, Andreas, University Hospital Bern, Bern, Switzerland
  • Brandi, Lisbet, Nordsjællands Hospital, Hillerød, Denmark
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.