Abstract: TH-PO1131
Prevalence and Predictors of Hypomagnesemia in CKD
Session Information
- Fluid, Electrolyte, Acid-Base Disorders
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Fluid, Electrolytes, and Acid-Base
- 704 Fluid, Electrolyte, Acid-Base Disorders
Authors
- Aggarwal (Gupta), Monika, Hunter Holmes McGuire VAMC, Richmond, Virginia, United States
- Feldman, George M., Hunter Holmes McGuire VAMC, Richmond, Virginia, United States
Background
Hypomagnesemia has been reported in patients with chronic kidney disease (CKD), and shown to be associated with progression of CKD and increased mortality. We studied the prevalence and predictors of hypomagnesemia in patients with CKD.
Methods
We reviewed charts of all patients (n=891) seen in our outpatient CKD clinic in the year 2014, at Hunter Holmes McGuire Veterans Affairs Medical Center. We collected five most recent serum values for magnesium, creatinine, estimated glomerular filtration rate (EGFR), calcium, phosphorus, parathyroid hormone intact (PTH) and 25(OH) Vitamin D, presence of diabetes, and use of diuretics, proton pump inhibitors (PPI), phosphate binders, and magnesium supplementation in past 5 years. Hypomagnesemia was defined as serum magnesium less than 1.8 mg/dl or a serum magnesium >1.8 mg/dl on magnesium supplement. We then determined possible associations of plasma magnesium with age, presence of diabetes, use of PPI, diuretics, and phosphate binders, and mean values of serum calcium, phosphorus, eGFR, PTH, and 25(OH)Vitamin D.
Results
Mean age was 70.01+10.87 years. All patients were male, with 60.36% (N=536) with diabetes. 53% (N=471) had stage 3 CKD. 57.9 % (N=514) were on a PPI. 32% (N=286) were on magnesium supplement. 33.67% (N=299) had a mean serum magnesium <1.8 mg/dl. While 66.33% (N=589) had a mean serum magnesium > 1.8 mg/dl, 121 of those patients were on magnesium supplement. Hence, 47.29% (N=420) had hypomagnesemia. Presence of diabetes mellitus, use of potassium supplement, thiazide diuretics, and PPI increased odds of having hypomagnesemia (Table 1).
Conclusion
Hypomagnesemia is common in patients with CKD. Use of PPI and presence of diabetes have the highest odds of developing hypomagnesemia.
Table 1.
coeff b | s.e. | Wald | p-value | exp(b) | lower | upper | |
Intercept | -0.02893 | 0.56849 | 0.00259 | 0.959413 | 0.971484 | ||
Age(Years) | -0.02309 | 0.006616 | 12.17748 | 0.000484 | 0.977178 | 0.964589 | 0.989931 |
EGFR | 0.005358 | 0.003327 | 2.593387 | 0.107311 | 1.005372 | 0.998838 | 1.011949 |
Diabetes | 0.47146 | 0.145743 | 10.46443 | 0.001217 | 1.602332 | 1.204193 | 2.132107 |
PPI | 0.589063 | 0.143496 | 16.8517 | 4.04E-05 | 1.802299 | 1.360451 | 2.387651 |
Potassium Supplement | 0.315967 | 0.156103 | 4.096938 | 0.042961 | 1.371584 | 1.01006 | 1.862506 |
Thiazide Diuretics | 0.390187 | 0.148757 | 6.88003 | 0.008716 | 1.477257 | 1.103656 | 1.977327 |
Funding
- Clinical Revenue Support