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Abstract: PO1301

Plasmatic Magnesium as a Marker of Nutrition and Inflammation in Peritoneal Dialysis?

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Domingos, Ana T., Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Marques, Roberto Calças, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Guedes, Anabela M., Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Laranjo, Céu, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Bernardo, Idalécio, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Neves, Pedro Leao, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
Background

There’s an important prevalence of hypomagnesemia (hypoMg) in Peritoneal Dialysis (PD), namely due to magnesium (Mg2+) losses in the dialysate. HypoMg has recently been associated with increased mortality in PD, a clearer fact in Hemodialysis. Processes involved seem to include alterations in body composition (BC) and inflammation, known as predictors of mortality in PD, beyond the risks immediately associated with hypoMg such as cardiac arrythmias. The aim of this study was to evaluate the correlations between plasmatic Mg2+ (pMg), BC, inflammation and nutrition in PD.

Methods

A prospective study included patients admitted at our Unit between 2010 and 2019, with simultaneous acquisition of bioelectrical impedance analysis (BIA) and pMg levels. Clinical and biochemical data were collected from clinical records. Spearman rank-correlation coefficient was used to report correlations.

Results

54 patients were enrolled (mean age of 54.2±17.6 years, 61% men, 86.3% hypertensive and 33.3% diabetic). Mean pMg was 2.1±0.37 mg/dL and high-sensitivity C-reactive protein (hs-CRP) 10.8±20 mg/L. Inverse correlations were found between pMg and fat mass (rs=-0.356, p=0.009), body mass index (BMI) (rs=-0.414, p=0.002) and hs-CRP (rs=-0.334, p=0.014). Regarding serum markers of nutrition, a correlation with pre-albumin (rs=0.297, p= 0.036) was found. No correlations with phase angle, ratio of extracellular mass to body cell mass, lean body mass index, serum albumin, creatinine, total protein, total cholesterol or transferrin were found. Hs-CRP in turn correlates with BMI (rs=0.309, p=0.023), inversely with pre-albumin (rs=-0.353, p=0.012) and has a tendency to correlation with fat mass (rs=0.254, p=0.052) and albumin (rs=-0.267, p=0.051).

Conclusion

Lower pMg is associated with increased fat mass and higher BMI. No correlations were found with other nutrition markers. The obesity paradox is still controversial in PD and some authors defend that an elevated BMI is associated with neutral to deleterious impact on PD outcomes, fact explained by fat mass. Proinflammatory effects are also well described in relation to obesity in PD. In conclusion, hypoMg seems associated with poorer nutrition, increased fat mass and inflammation. Dietary interventions with Mg2+ supplementation could address this problem and should be a target of interventional studies.