Abstract: TH-PO1131

Prevalence and Predictors of Hypomagnesemia in CKD

Session Information

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 bs.e.Waldp-valueexp(b)lowerupper
Intercept-0.028930.568490.002590.9594130.971484  
Age(Years)-0.023090.00661612.177480.0004840.9771780.9645890.989931
EGFR0.0053580.0033272.5933870.1073111.0053720.9988381.011949
Diabetes0.471460.14574310.464430.0012171.6023321.2041932.132107
PPI0.5890630.14349616.85174.04E-051.8022991.3604512.387651
Potassium Supplement0.3159670.1561034.0969380.0429611.3715841.010061.862506
Thiazide Diuretics0.3901870.1487576.880030.0087161.4772571.1036561.977327
        

Funding

  • Clinical Revenue Support