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Kidney Week

Abstract: PO0458

Baseline Serum Magnesium and Risk of CKD Progression in the Chronic Renal Insufficiency Cohort (CRIC) Study

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Correa, Simon, Brigham and Women's Hospital, Boston, Massachusetts, United States
  • Waikar, Sushrut S., Boston Medical Center, Boston, Massachusetts, United States
  • McCausland, Finnian R., Brigham and Women's Hospital, Boston, Massachusetts, United States
Background

Serum magnesium (sMg) concentration is regulated by intestinal absorption and renal handling which are impaired in CKD. While Mg has been implicated in blood pressure regulation and sMg has been associated with the risk of hypertension, the association of sMg with long-term risk of CKD progression remains unclear.

Methods

Adjusted cox-proportional hazard regression models were fit to determine the association of baseline sMg with CKD progression in CRIC. CKD progression was defined as 1) development of end-stage renal disease (renal transplantation or dialysis initiation) or 2) a 50% decline in baseline eGFR (CKD-EPI). All models were stratified by clinical site and adjusted for demographics, BMI, DM, CV comorbidities, hematocrit, baseline eGFR CKD-EPI, serum albumin, 24-hour urine protein, serum and urine electrolytes, total-PTH, CV biomarkers associated with CKD progression, antihypertensive medications and diuretics. Adjusted splines were also fit.

Results

We analyzed data from 3,866 participants from CRIC who had sMg assessed at baseline. Median sMg was 2.0 mEq/L (25th-75th percentile 1.9 to 2.1 mEq/L). After multivariate adjustment, higher baseline sMg was associated with a 27% lower hazard of CKD progression (aHR 0.73, 95% CI 0.58-0.92; P<0.01, per 1 mEq/L). Compared to the lowest quartile (Q1), sMg concentration in the top quartile (Q4) was associated with a 23% lower hazard of CKD progression (aHR Q1:Q4 0.78, 95% CI 0.65-0.94; P<0.01). The adjusted relationship of sMg with CKD progression appeared to be linear (Fig 1).

Conclusion

In patients with CKD, higher sMg is associated with a lower risk of CKD progression independent of clinical and biochemical data. Whether correction of hypomagnesemia prevents CKD progression deserves future prospective studies.