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Abstract: TH-PO212

Serum Magnesium Value at 1 Year After Initiation of Hemodialysis Is a Significant Predictive Factor of All-Cause Mortality

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Fujii, Takayuki, Seirei Sakura Citizen Hospital, SAKURA-SHI, CHIBA, Japan
  • Saito, Kaiji, Seirei Sakura Citizen Hospital, SAKURA-SHI, CHIBA, Japan
  • Koshizaka, Junya, Seirei Sakura Citizen Hospital, SAKURA-SHI, Japan
  • Yamauchi, Nobuaki, Seirei Sakura Citizen Hospital, SAKURA-SHI, Japan
  • Terasaki, Noriko, Seirei Sakura Citizen Hospital, SAKURA-SHI, CHIBA, Japan
  • Hiroaki, Tanaka, Seirei Sakura Citizen Hospital, SAKURA-SHI, CHIBA, Japan
  • Suzuki, Satoshi, Seirei Sakura Citizen Hospital, SAKURA-SHI, CHIBA, Japan
Background

Recent studies reported that higher levels of serum magnesium (Mg) were associated with better prognosis in patients undergoing hemodialysis. However, it remains unclear which measurement point of the serum Mg value is crucial for vital prognosis after initiation of hemodialysis. In this study, we evaluated the association of serum Mg for 3 years after initiation of hemodialysis with subsequent all-cause mortality.

Methods

We conducted a single-center retrospective cohort study in 205 patients who initiated hemodialysis between March 2004 and May 2014 and could be followed-up for at least three years or more. We analyzed the influence of annual serum Mg value on all-cause mortality for 3 years using Cox’s hazard proportional model. The hazard ratio (HR) of all-cause mortality was adjusted for demographic data, 3-year-averaged laboratory data and medications.

Results

The median follow-up period was 6.1years and fifty patients reached the outcome. Since the median of 3-year-averaged Mg level was 2.6mg/dl, we evaluated the significance of Mg≥2.6mg/dL versus Mg<2.6mg/dL using Cox’s proportional hazard model. Although, at the time of initiation of hemodialysis, HR of Mg≥2.6mg/dL was 1.15[0.52-2.26], HRs of Mg≥2.6mg/dL at 1 year, 2 years and 3 years after initiation of hemodialysis, were 0.33[0.15-0.74], 0.41[0.15-0.74] and 0.30[0.16-0.53] and found to be significant factors in univariate analysis. Even adjusted for age, presence of diabetes, 3-year-averaged serum albumin and phosphorus and use of non-calcium containing phosphate binder, which were also significant factors in univariate analysis, HRs of Mg≥2.6mg/dL at 1 year, 2 years and 3 years were 0.48[0.26-0.87], 0.45[0.25-0.82] and 0.50[0.26-0.96], respectively, showing that Mg≥2.6mg/dL was a significantly better prognostic factor at 1 year or longer after hemodialysis initiation.

Conclusion

In this study, we found that higher levels of serum Mg at 1 year or later after initiation of hemodialysis were associated with subsequent better prognosis.