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Abstract: TH-PO213

Hypomagnesemia and Body Composition in Maintenance Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Mizuiri, Sonoo, Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Nishizawa, Yoshiko, Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Yamashita, Kazuomi, Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Ono, Kyoka, Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Usui, Kohji, Ichiyokai Ichiyokai Clinic, Hiroshima, Japan
  • Arita, Michiko, Ichiyokai East Clinic, Hiroshima , Japan
  • Naito, Takayuki, Ichiyokai Yokokawa Clinic, Hiroshima, Japan
  • Doi, Shigehiro, Hiroshima University Hospital, Hiroshima, Japan
  • Masaki, Takao, Hiroshima University Hospital, Hiroshima, Japan
  • Shigemoto, Kenichiro, Division of Nephrology, Ichiyokai Harada Hospital, Hiroshima, Japan
Background

The aim of this study was to investigate the relationships between serum magnesium (Mg) levels and body composition, clinical parameters, or survival in maintenance hemodialysis (MHD) patients.

Methods

The subjects were 215 MHD patients on dialysate Mg of 1.0 mEq/L. Pre-dialysis laboratory data collection and post-dialysis body composition analysis with the Body Composition Monitor® (Fresenius Medical Care) were performed at the baseline. The patients were divided into serum Mg tertiles [T1-3]. Kaplan-Meier survival, and logistic regression analyses for T1 were examined.

Results

Among all patients, the mean age was 72±12 years, 39.1% were diabetics, and the median dialysis vintage was 44 (8-96) months. The serum Mg values of T1 (n=67), T2 (n=76) and T3 (n=72) were <2.3, 2.3-2.5 and >2.5 mg/dl, respectively. The differences in body cell mass index (BCMI) among T1, T2, and T3 were significant (5.7±1.9, 6.4±2.1, 6.6±2.2 kg/m2, p<0.05), as were those in overhydration/extracellular water ratio (OH/ECW) (15.1±16.5, 7.1±11.1, 9.1±14.2%, p<0.01), but no significant differences were seen for the body mass index (20.2±5.3, 22.1±6.4, 20.3±4.9 kg/m2), lean tissue index (11.2±2.6, 12.0±3.3, 12.1±3.0 kg/m2), or fat tissue index (8.0±3.7, 9.1±4.4, 8.7±4.6 kg/m2). T1 exhibited a significantly greater age (75±11, 73±12, 69±13 years), a shorter dialysis vintage, and lower normalized protein nitrogen appearance (nPNA), serum albumin (3.2±0.5, 3.3±0.4, 3.4±0.5 g/dl) and uric acid values (6.5±1.7, 6.9±1.4, 7.2±1.4 mg/dl) but higher C-reactive protein levels (1.4±2.4, 1.1±2.7, 0.9±1.9 mg/dl) compared with T2 and T3 (p<0.05). During the 3 years, 47 (21.9%) patients died. Three-year survival rates were 57.7% and 67.9% in T1 and T2+T3, respectively (p<0.05). Multivariate analyses included all significant variables in the univariate analyses showed that T1 was significantly associated with the BCMI [Odds ratio (OR) 0.83, 95% confidence interval (CI) 0.70-0.97] or OH/ECW [OR (95%CI): 1.03 (1.01-1.06)], respectively, independent of age, dialysis vintage, nPNA, serum albumin and uric acid levels (p<0.05).

Conclusion

Hypomagnesemia is associated with lower 3-year survival rate, and worse body composition parameters such as BCMI and OH/ECW, which reflect muscle depletion and overhydration, respectively, in MHD patients.

Funding

  • Private Foundation Support