Review article

MAGNESIUM HOMEOSTASIS DISORDER IN PATIENTS WITH CHRONIC KIDNEY DISEASE

MATIJA RICOV ; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia
GRGUR SALAI ; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia
VLATKA SIGUR ; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia
ANTON ŠERIĆ ; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia
NIKOLINA BAŠIĆ-JUKIĆ orcid.org/0000-0002-0221-2758 ; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia

Abstract

Magnesium is an important intracellular cation that acts as a cofactor in over 600 biochemical reactions. Concentration range of magnesium is strictly regulated by intestinal absorption, renal excretion and via cellular and bone buffering; thus determining magnesium concentration in serum may not be suffi cient to fully assess magnesium levels in the body. Chronic kidney disease (CKD) progression leads to a decrease in glomerular fi ltration resulting in hypermagnesemia. The aim of this article is to increase the awareness of magnesium homeostasis disorders in CKD and possible repercussions of magnesium imbalance. Concentration of magnesium in dialysis fl uid should be determined very carefully during hemodialysis. Hypomagnesemia often occurs when dialysis fl uid without magnesium is used, while using dialysis fl uid with higher magnesium concentrations has been reported to have less side effects. Patients on dialysis often have hypermagnesemia, while hypomagnesemia is connected with lower absorption in jejunum. Connection between peritoneal dialysis and hypomagnesemia is not fully investigated. Hypomagnesemia is common in patients with kidney transplant. There are many mechanisms through which hypomagnesemia increases mortality rate in patients with CKD, including increased rate of blood vessel calcifi cation, pro-diabetic effects, increasing the risk of dyslipidemia and metabolic syndrome. Furthermore, severe hypomagnesemia can cause fatal heart arrhythmias. A consensus regarding magnesium supplementation in patients with CKD has not been reached, although some studies have shown that it might prevent longterm complications and cardiovascular incidents.

Keywords

magnesium; chronic kidney disease; dialysis; kidney transplantation

Hrčak ID:

259262

URI

https://hrcak.srce.hr/259262

Publication date:

19.6.2021.

Article data in other languages: croatian

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