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Abstract: SA-PO262

Assessment of the Confounding Factors to Affect Life Prognosis of Serum Magnesium in Hemodialysis Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Ogawa, Chie, Maeda Institute of Renal Research, Kawasaki, Japan
  • Tsuchiya, Ken, Tokyo Women's Medical University, Tokyo, Japan
  • Kanda, Fumiyoshi, Maeda Institute of Renal Research, Kawasaki, Japan
  • Maeda, Kunimi, Maeda Institute of Renal Research, Kawasaki, Japan
Background

Recently, some studies reported that hypomagnesemia was associated with mortality and cardiovascular events. However, optimal levels of serum magnesium (s-Mg) is unknown in hemodialysis (HD) patients. We have measured s-Mg levels once a month in HD patients. So, to identify the appropriate s-Mg levels, a 9-year survey was performed to investigate the relationships between s-Mg levels and a prognosis in HD patients. Moreover, the factors to affect s-Mg level were examined.

Methods

148 HD-outpatients under seventy years old were followed from January 2009 to December 2018. Patients were divided to two groups according to the mean s-Mg levels during the first year period. Cutoff-point of s-Mg levels was used 2.5mg/dL, upper value of normal range in healthy subjects. The outcome was all-cause mortality/hospitalization due to be impossible of HD-outpatient. Statistical analyses were used Kaplan-Meier, log-rank tests and the Cox proportional hazards model. Then, multiple regression analysis was performed to examine factors related to s-Mg levels.

Results

The range of mean s-Mg levels for the first year was 1.9-3.8mg/dL. The survival rate in the s-Mg levels ≤2.5mg/dL group was significantly lower than that in the s-Mg levels >2.5mg/dL group (39.0% vs 72.0%; P < 0.001). The multivariate Cox proportional hazards model (stepwise method) showed that the risk of mortality/hospitalization were significantly higher in the s-Mg levels ≤2.5mg/dL group compared with the s-Mg levels >2.5mg/dL group (hazard ratio; 1.89; 95% confidence interval, 1.08–3.28, P = 0.025). Multiple regression analysis showed that s-Mg levels were associated with age, serum albumin and corrected calcium [serum calcium (mg/dL) + 4.0 - serum albumin (g/dL)]

Conclusion

This study indicated the s-Mg levels ≤2.5mg/dL was associated with high mortality/hospitalization in HD patients. The optimal s-Mg levels in HD patients may be higher level than that in healthy subject. Moreover, s-Mg levels may be affected by age, nutritional condition and calcium metabolism.

Multiple stepwise regression analysis for serum magnesium
 β95% confidence intervalP valueR2
(Intercept) (-0.233 - 2.672)0.1000.17
age (years)-0.008(-0.014 - -0.002)0.009 
serum albumin (g/dL)0.267(0.069 - 0.464)0.008 
corrected calcium (mg/dL)0.100(0.003 - 0.195)0.044