Prognostic Value of Serum Magnesium in Mortality Risk among Patients on Hemodialysis: A Meta-Analysis of Observational Studies
Kidney Dis (Basel). 2021 Jan;7(1):24-33. doi: 10.1159/000510513
Hongwei Wu 1, Qiang Li 2, Lijing Fan 1, Dewang Zeng 1 3, Xianggeng Chi 4 5, Baozhang Guan 1, Bo Hu 1, Yongping Lu 1 5, Chen Yun 5, Bernhard Krämer 5, Berthold Hocher 1 5, Fanna Liu 1, Lianghong Yin 1
Magnesium and Kidney
- Patients on Hemodialysis 3X more likely if die of heart failure if low Magnesium – meta-analysis Jan 2021
- Hypothesis: Magnesium might prevent and treat Chronic Kidney Disease – April 2018
- Vitamin D level can be high, but little benefit: due to kidney, genes, low Magnesium etc.
- Kidney disease requires magnesium - Jan 2013
Magnesium and Mortality
- Patients on Hemodialysis 3X more likely if die of heart failure if low Magnesium – meta-analysis Jan 2021
- Death after Breast Cancer 2 times less likely if take lots of Magnesium – Dec 2015
- All-cause mortality is related to low Magnesium, rather than low Vitamin D – April 2015
- Low Magnesium in 40 percent of critical care patients – increased hospital days and death - Jan 2014
- Correcting magnesium deficiencies may prolong life – Space Station Feb 2012
Note: there is a strong association between low Magnesium and low Vitamin D
- Hemodialysis patients (CKD) helped by weekly 50,000 IU of vitamin D – Jan 2017
- Hemodialysis with low vitamin D increases risk of 2 health problems by 10 percent – Aug 2020
- Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012
- 4X more Chronic Kidney disease patients are now using vitamin D – March 2014
- Peritoneal dialysis probably consumes a lot more vitamin D than haemodialysis
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subset of table in PDF
Background: Previous studies have reported that serum magnesium (Mg) deficiency is involved in the development of heart failure, particularly in patients with end-stage kidney disease. The association between serum Mg levels and mortality risk in patients receiving hemodialysis is controversial. We aimed to estimate the prognostic value of serum Mg concentration on all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.
Methods: We did a systematic literature search in PubMed, EMBASE, Cochrane Library, and Web of Science to identify eligible studies that reported the prognostic value of serum Mg levels in mortality risk among patients on hemodialysis. We performed a meta-analysis by pooling and analyzing hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: We identified 13 observational studies with an overall sample of 42,967 hemodialysis patients. Higher all-cause mortality (adjusted HR 1.58 [95% CI: 1.31-1.91]) and higher cardiovascular mortality (adjusted HR 3.08 [95% CI: 1.27-7.50]) were found in patients with lower serum Mg levels after multivariable adjustment. There was marked heterogeneity ( I 2 = 79.6%, p < 0.001) that was partly explained by differences in age stratification and study area. In addition, subgroup analysis showed that a serum Mg concentration of ≤1.1 mmol/L might be the vigilant cutoff value.