Kidney Week

Abstract: SA-PO844

Significant Association between Serum Magnesium and the Elevation of Troponin T in Maintenance Hemodialysis Patients

Session Information

• Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular - II
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

• Ishimura, Eiji, Meijibashi Hospital, Osaka, Japan

Eiji Ishimura,

• Nakatani, Shinya, Osaka City University Graduate School of Medicine, Osaka, Japan

Shinya Nakatani,

• Tsuda, Akihiro, Osaka City University Graduate School of Medicine, Osaka, Japan

Akihiro Tsuda,

• Kuwamura, Nobuyuki, Meijibashi Hospital, Osaka, Japan

Nobuyuki Kuwamura,

• Kakiya, Ryusuke, Meijibashi Hospital, Osaka, Japan

Ryusuke Kakiya,

• Miyawaki, Jiro, Shirasagi Hospital, Osaka, Japan

Jiro Miyawaki,

• Okuno, Senji, Shirasagi Hospital, Osaka, Japan

Senji Okuno,

• Yamakawa, Tomoyuki, Shirasagi Hospital, Osaka, Japan

Tomoyuki Yamakawa,

• Shoji, Shigeichi, Shirasagi Hospital, Osaka, Japan

Shigeichi Shoji,

• Inaba, Masaaki, Osaka City University Graduate School of Medicine, Osaka, Japan

Masaaki Inaba,

Background

Serum magnesium (Mg) levels is well known to be closely associated with cardiovascular disease in the general population. Troponin T has been reported to be a cardiac contractility modulating protein, and is measured as a biomarker for diagnosing myocardial injury. In hemodialysis patients, serum troponin T is elevated, and elevated serum troponin T has been reported to be a risk of death from all-cause mortality and cardiovascular disease. We hypothesized that serum Mg would be associated with the elevation of troponin T in hemodialysis patients.

Methods

A total of 432 stable maintenacne hemodialysis patients were examined (age: 64.0±11.3 years, hemodialysis duration: 8.0±6.9 years, 63.7% men, and 37.5% diabetics). Troponin T was measured twice in one year interval. Patients were divided into two groups; the group with elevation of serum troponin T in a year (98 patients) and the group with its non-elevation (334 patients).

Results

The group of elevation of serum troponin T showed significant older age, compared to the group of no-elevation of serum troponin T (67± 10 vs. 63 ± 12 vs. years, p = 0.0006) . Cardia thoracic ratio (CTR) was significantly larger in the former than in the latter (50.5 ± 4.7 vs. 49.3 ± 4.4 %, p = 0.0260) . Body mass index or duration of hemodialysis did not significantly differ between the two groups. Serum magnesium concentrations were significantly lower in the group of elevation of serum troponin T in a year, compared to the group of no elevation of serum troponin T in a year (2.6 ± 0.3 vs. 2.8 ± 0.4 mg/dL, p = 0.0015), although there were no significant differences in serum calcium, phosphate or intact PTH between the two groups. In a multivariate logistic analysis, serum Mg levels (OR = 0.394; 95% CI, 0.177 to 0.877; p = 0.0224) were significantly and independently associated with the elevation of troponin T, in addition to other significant factors of age, hemodialysis duration, and smoking (R²=0.097, p < 0.0001), after adjustment of several clinical factors.

Conclusion

These results demonstrated that lower serum Mg concentration was significantly associated with the elevation of troponin T in hemodialysis patients, possibly suggesting that significant association of lower serum Mg and higher cardiac injury.