Magnesium levels in children with chronic kidney disease stages 1-3
Abstract
Objective: The objective of this study was to assess serum and urinary magnesium levels in children who have chronic kidney disease stages 1-3. Methods: Eighty-seven patients who were followed at pediatric nephrology department for chronic kidney disease were included in the study. Age, gender, magnesium, dietary magnesium, and creatinine levels, and fractionated magnesium excretion for all cases were recorded. Patients with chronic kidney disease and control groups were compared in terms of these data. Results: Thirty-nine cases with chronic kidney disease were stage 1, 26 were stage 2, and 22 were stage 3. Average age was 9.9 ± 2.8 years in the control group and 10.2 ± 2.6 years in the chronic kidney disease group. The serum magnesium levels were significantly higher in the stage 3 group than in the control group (P<0.001). Also, in stage 3, fractionated magnesium excretion levels were higher compared to the control group (P<0.001). Conclusion: In chronic kidney disease with advancing renal failure, hypermagnesemia is frequently seen. Serum magnesium levels should be measured periodically in all the children with chronic kidney disease stage 3 to investigate magnesium abnormalities and assess clinical results.
References
2) Massy ZA, Nistor I, Apetrii M, Brandenburg VM, Bover J, Evenepoel P, et al. Magnesium-based interventions for normal kidney function and chronic kidney disease. Magnes Res. 2016;29(4):126-40. doi: 10.1684/mrh.2016.0412.
3) Stevens PE, Levin A; Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158(11):825-30. doi: 10.7326/0003-4819-158-11-201306040-00007.
4) de Francisco ALM, Rodríguez M. Magnesium its role in CKD. Nefrologia. 2013;33(3):389-99. doi: 10.3265/Nefrologia.pre2013.
5) Cunningham J, Rodríguez M, Messa P. Magnesium in chronic kidney disease Stages 3 and 4 and in dialysis patients. Clin Kidney J. 2012;5(Suppl. 1):i39-i51. doi: 10.1093/ndtplus/sfr166.
6) Felsenfeld AJ, Levine BS, Rodriguez M. Pathophysiology of calcium, phosphorus, and magnesium dysregulation in chronic kidney disease. Semin Dial. 2015;28(6):564-77. doi: 10.1111/sdi.12411.
7) Schwalfenberg GK, Genuis SJ. The importance of magnesium in clinical healthcare. Scientifica (Cairo). 2017;2017:4179326. doi: 10.1155/2017/4179326.
8) Laires MJ, Monteiro CP, Bicho M. Role of cellular magnesium in health and human disease. Front Biosci. 2004;9:262-76. doi: 10.2741/1223.
9) Hoorn EJ, Zietse R. Disorders of calcium and magnesium balance: a physiology-based approach. Pediatr Nephrol. 2013;28(8):1195-206. doi: 10.1007/s00467-012-2350-2.
10) Wolf MT. Inherited and acquired disorders of magnesium homeostasis. Curr Opin Pediatr. 2017;29(2):187-98. doi: 10.1097/MOP.0000000000000450.
11) Seo JW, Park TJ. Magnesium metabolism. Electrolyte Blood Press. 2008;6(2):86-95. doi: 10.5049/EBP.2008.6.2.86.
12) Xiong J, He T, Wang M, Nie L, Zhang Y, Wang Y, et al. Serum magnesium, mortality, and cardiovascular disease in chronic kidney disease and end-stage renal disease patients: a systematic review and meta-analysis. J Nephrol. 2019;32(5):791-802. doi: 10.1007/s40620-019-00601-6.
13) Leenders NHJ, Vervloet MG. Magnesium: a magic bullet for cardiovascular disease in chronic kidney disease? Nutrients. 2019;11(2):455. doi: 10.3390/nu11020455.
14) Stark CM, Nylund CM, Gorman GH, Lechner BL. Primary renal magnesium wasting: an unusual clinical picture of exercise-induced symptoms. Physiol Rep. 2016;4(8):e12773. doi: 10.14814/phy2.12773.
15) Dewitte K, Dhondt A, Giri M, Stöckl D, Rottiers R, Lameire N, et al. Differences in serum ionized and total magnesium values during chronic renal failure between nondiabetic and diabetic patients: a cross-sectional study. Diabetes Care. 2004;27(10):2503-5. doi: 10.2337/diacare.27.10.2503.
16) Apetrii M, Covic A, Massy ZA. Magnesium supplementation: a consideration in dialysis patients. Semin Dial. 2018;31(1):11-14. doi: 10.1111/sdi.12653.
17) Tsai S, Zhao H, Wu B, Zuo L, Wang M. Serum Magnesium abnormality and influencing factors of serum magnesium level in peritoneal dialysis patients: a single-center study in northern China. Blood Purif. 2018;45(1-3):110-117. doi: 10.1159/000485315.
18) Assadi F. Hypomagnesemia: an evidence-based approach to clinical cases. Iran J Kidney Dis. 2010;4(1):13-9.
19) Laires MJ, Monteiro CP, Bicho M. Role of cellular magnesium in health and human disease. Front Biosci. 2004;9:262-76. doi: 10.2741/1223.
20) Yu ASL, Yarlagadda SG. Hypomagnesemia: clinical manifestations of magnesium depletion [Internet]. En: UpToDate. Disponible en:
21) Baker SB, Worthley LI. The essentials of calcium, magnesium and phosphate metabolism: part II. Disorders. Crit Care Resusc. 2002;4(4):307-15.
22) Floege J. Magnesium in CKD: more than a calcification inhibitor? J Nephrol. 2015;28(3):269-77. doi: 10.1007/s40620-014-0140-6.
23) Cai K, Luo Q, Dai Z, Zhu B, Fei J, Xue C, et al. Hypomagnesemia is associated with increased mortality among peritoneal dialysis patients. PLoS One.2016;11(3):e0152488. doi: 10.1371/journal.pone.0152488.
24) Toprak O, Kurt H, Sarı Y, Şarkış C, Us H, Kırık A. Magnesium replacement improves the metabolic profile in obese and pre-diabetic patients with mild-to-moderate chronic kidney disease: a 3-month, randomised, double-blind, placebo-controlled study. Kidney Blood Press Res. 2017;42(1):33-42. doi: 10.1159/000468530.
25) Yorifuji M, Kuragano T, Kawada S, Fukao W, Toyoda K, Nakanishi T. Factors associated with serum magnesium and vascular stiffness in maintenance hemodialysis patients. Hemodial Int. 2018;22(3):342-50. doi: 10.1111/hdi.12625.
26) Molnar AO, Biyani M, Hammond I, Harmon JP, Lavoie S, McCormick B, et al. Lower serum magnesium is associated with vascular calcification in peritoneal dialysis patients: a cross sectional study. BMC Nephrol. 2017;18(1):129. doi: 10.1186/s12882-017-0549-y.
Copyright (c) 2021 Revista de Nefrología, Diálisis y Trasplante
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.