Kidney Week

Abstract: FR-PO916

Ionized and Total Magnesium Levels and Cardiovascular Risk in Patients with CKD

Session Information

• CKD Epidemiology, Risk Factors, Prevention - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Laville, Solene M., Centre Hospitalier Universitaire Amiens-Picardie, Amiens, Hauts-de-France, France

Solene M. Laville,

• Pluquet, Maxime, Universite de Picardie Jules Verne, Amiens, Hauts-de-France, France

Maxime Pluquet,

• Mansencal, Nicolas, Ambroise Paré University Hospital, Cardiology department, Boulogne-Billancourt, Ile-De-France, France

Nicolas Mansencal,

• Fouque, Denis, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes , France

Denis Fouque,

• Laville, Maurice, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes , France

Maurice Laville,

• Frimat, Luc, Centre Hospitalier Regional Universitaire de Nancy, Nancy, Grand Est, France

Luc Frimat,

• Massy, Ziad, Hopital Ambroise-Pare Service de Nephrologie Dialyse, Boulogne-Billancourt, Île-de-France, France

Ziad Massy,

• Kamel, Said, Universite de Picardie Jules Verne, Amiens, Hauts-de-France, France

Said Kamel,

• Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France

Natalia Alencar de Pinho,

• Liabeuf, Sophie, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, Hauts-de-France, France

Sophie Liabeuf,

Background

We sought to determine whether serum ionized (iMg) and total (tMg) Mg levels are associated with major adverse cardiovascular events (MACE) in patients with CKD.

Methods

CKD-REIN is a prospective cohort of CKD outpatients (not on dialysis). Baseline iMg and tMg serum concentrations were respectively centrally measured using the NOVA BIOMEDICAL Stat Profile PRIME ES and with Atellica® CH SIEMENS analyzers. Adjusted cause-specific Cox proportional hazard models were used to estimate hazard ratios (HRs) for first MACE (CV death, myocardial infarction, stroke or hospitalization for heart failure).

Results

Of the 2419 included patients (median [IQR] age: 68[60-76]; mean (SD) eGFR 33.5(13.5) mL/min/1.73 m²), 52% had a history of CV disease.
Correlation between iMg and tMg was very high (r=0.88; p<0.001).
Over a median follow-up of 4.4 years [IQR,2.3-5.0], 351 experienced a first MACE event, leading to an incidence rate [95%CI] of 3.9[3.5;4.3] per 100 person-years (figure).
After multiple adjustments, patients in Tertile 3 (T3) of iMg had a higher risk of MACE compared to patients in Tertile 1 (T1), HR [95% CI], 1.39[1.05;1.83]. No difference was noted for patients in Tertile 2 (T2) compared to patients in T1.
Regarding tMg, patients in T3 of total Mg had a higher risk of MACE compared to patients in T1 (HR=1.40[1.07;1.83]). A nonsignificant lower risk of MACE was noted for patients in T2 compared to patients in T1, revealing a potential U shape relation between MACE risk and tMg level.

Conclusion

This study suggests that high serum iMg and tMg levels are associated to cardiovascular outcomes in patients with moderate to advanced CKD. Further research is needed to explore the shape of the relationships and the mechanisms.

Funding

• Government Support – Non-U.S.