Yonsei Med J.  2016 Nov;57(6):1446-1453. 10.3349/ymj.2016.57.6.1446.

The Relationship between Magnesium and Endothelial Function in End-Stage Renal Disease Patients on Hemodialysis

• Lee S
• Ryu JH
• Kim SJ
• Ryu DR
• Kang DH
• Choi KB

• KMID: 2427163
• DOI: http://doi.org/10.3349/ymj.2016.57.6.1446

Abstract

PURPOSE
Chronic kidney disease (CKD) patients tend to have higher serum magnesium values than healthy population due to their positive balance of magnesium in kidney. Recent studies found that magnesium level is positively correlated with endothelial function. Therefore, this study was conducted to define the relationship between magnesium level and endothelial dysfunction in end stage renal disease (ESRD) patients on hemodialysis (HD).
MATERIALS AND METHODS
A total of 27 patients were included in this cross-sectional study. Iontophoresis with laser-Doppler flowmetry, flow mediated dilation (FMD), and carotid intima-media thickness were measured. Patients' average serum magnesium levels were measured over previous three months, including the examination month. Pearson's correlation coefficient analysis and multivariate regression model were used to define the association between magnesium and endothelial function.
RESULTS
In the univariate analysis, higher magnesium levels were associated with better endothelium-dependent vasodilation (EDV) of the FMD in ESRD patients on HD (r=0.516, p=0.007). When the participants were divided into two groups according to the median magnesium level (3.47 mg/dL), there was a significant difference in EDV of FMD (less than 3.47 mg/dL, 2.8±1.7%; more than 3.47 mg/dL, 5.1±2.0%, p=0.004). In multivariate analysis, magnesium and albumin were identified as independent factors for FMD (β=1.794, p=0.030 for serum magnesium; β=3.642, p=0.012 for albumin).
CONCLUSION
This study demonstrated that higher serum magnesium level may be associated with better endothelial function in ESRD patients on HD. In the future, a large, prospective study is needed to elucidate optimal range of serum magnesium levels in ESRD on HD patients.

Keyword

Magnesium; hemodialysis; microcirculation; endothelium

MeSH Terms

Adult
Aged
Carotid Intima-Media Thickness
Cross-Sectional Studies
Endothelium, Vascular/pathology/physiology
Female
Humans
Kidney/*physiopathology
Kidney Failure, Chronic/*blood
Magnesium/*blood
Male
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
*Renal Dialysis
Renal Insufficiency, Chronic/blood
Vascular Diseases
Vasodilation
Magnesium

Figure

• 

  Fig. 1 Scatter plot of the relationships between serum magnesium concentration and endothelial function using iontophoresis with laser-Doppler flowmetry. Neither endothelium-dependent vascular dilation (A) nor endothelium-independent vascular dilation (B) was significantly related to serum magnesium. Ach, acetylcholine; SNP, sodium nitroprusside.

• 

  Fig. 2 Scatter plot of the relationships between serum magnesium concentration and endothelial function, measured by flow mediated dilation. Endothelium-dependent vasodilation (A) is significantly associated with serum magnesium. There is no significant trend in endothelium-independent vasodilatation (B).

• 

  Fig. 3 Negative relationship between serum magnesium concentration and carotid intima-media thickness (p=0.221).

• 

  Fig. 4 Positive relationship between serum magnesium concentration and iPTH (p=0.207). iPTH, intact parathyroid hormone.

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