Low serum magnesium is associated with faster decline in kidney function: The Dallas Heart Study experience

Silvia Ferrè, Xilong Li, Beverley A Huet, Naim M Maalouf, Khashayar Sakhaee, Robert D Toto, Orson W Moe, Javier A. Neyra

Research output: Contribution to journalArticle

Abstract

Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline. We hypothesized that low serum magnesium (SMg) levels independently associate with a significant decline in estimated glomerular filtration rate (eGFR). We analyzed SMg levels in 2056 participants from the Dallas Heart Study, a longitudinal, population-based, multiethnic, cohort study involving residents of Dallas County, Texas, USA. The primary study outcome was the change in eGFR using multivariable linear regression models adjusted for demographics, anthropometric and biochemical parameters, medications, C reactive protein levels, prevalent hypertension and diabetes. During a median follow-up of 7.0 years (25th, 75th percentile: 6.5, 7.6), the median decrease in eGFR was '0.71 (25th, 75th percentile: '2.43, +0.68) mL/min/1.73 m 2 per year in the entire cohort. In a fully adjusted model, the lowest SMg quintile (≤1.9 mg/dL or ≤0.8 mM) was associated with a '0.50 mL/min/1.73 m 2 per year drop in eGFR (95% CI '0.95 to -0.05; p=0.028) compared with the highest SMg quintile (≥2.3 mg/dL or ≥1.0 mM). Every 0.2 mg/dL (0.08 mM) decrease in SMg was associated with an eGFR decline of '0.23 mL/min/1.73 m 2 per year (95% CI '0.38 to -0.08; p=0.003), a decline that was more pronounced in participants with prevalent diabetes compared with patients without diabetes ('0.51 vs '0.18 mL/min/1.73 m 2 per year, respectively). In conclusion, low SMg was independently associated with eGFR decline. Further studies are needed to determine whether Mg repletion can ameliorate inflammation, lower blood pressure and serum glucose and ultimately prevent or retard kidney function decline.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
DOIs
StatePublished - Jan 1 2019

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Magnesium
Glomerular Filtration Rate
Medical problems
Kidney
Serum
Linear Models
Hypertension
Inflammation
Blood pressure
Linear regression
C-Reactive Protein
Longitudinal Studies
Cohort Studies
Glucose
Demography
Outcome Assessment (Health Care)
Blood Pressure
Population

Keywords

  • chronic kidney disease
  • diabetes mellitus
  • hypertension
  • hypomagnesemia
  • magnesium

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

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title = "Low serum magnesium is associated with faster decline in kidney function: The Dallas Heart Study experience",
abstract = "Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline. We hypothesized that low serum magnesium (SMg) levels independently associate with a significant decline in estimated glomerular filtration rate (eGFR). We analyzed SMg levels in 2056 participants from the Dallas Heart Study, a longitudinal, population-based, multiethnic, cohort study involving residents of Dallas County, Texas, USA. The primary study outcome was the change in eGFR using multivariable linear regression models adjusted for demographics, anthropometric and biochemical parameters, medications, C reactive protein levels, prevalent hypertension and diabetes. During a median follow-up of 7.0 years (25th, 75th percentile: 6.5, 7.6), the median decrease in eGFR was '0.71 (25th, 75th percentile: '2.43, +0.68) mL/min/1.73 m 2 per year in the entire cohort. In a fully adjusted model, the lowest SMg quintile (≤1.9 mg/dL or ≤0.8 mM) was associated with a '0.50 mL/min/1.73 m 2 per year drop in eGFR (95{\%} CI '0.95 to -0.05; p=0.028) compared with the highest SMg quintile (≥2.3 mg/dL or ≥1.0 mM). Every 0.2 mg/dL (0.08 mM) decrease in SMg was associated with an eGFR decline of '0.23 mL/min/1.73 m 2 per year (95{\%} CI '0.38 to -0.08; p=0.003), a decline that was more pronounced in participants with prevalent diabetes compared with patients without diabetes ('0.51 vs '0.18 mL/min/1.73 m 2 per year, respectively). In conclusion, low SMg was independently associated with eGFR decline. Further studies are needed to determine whether Mg repletion can ameliorate inflammation, lower blood pressure and serum glucose and ultimately prevent or retard kidney function decline.",
keywords = "chronic kidney disease, diabetes mellitus, hypertension, hypomagnesemia, magnesium",
author = "Silvia Ferr{\`e} and Xilong Li and Huet, {Beverley A} and Maalouf, {Naim M} and Khashayar Sakhaee and Toto, {Robert D} and Moe, {Orson W} and Neyra, {Javier A.}",
year = "2019",
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doi = "10.1136/jim-2018-000966",
language = "English (US)",
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TY - JOUR

T1 - Low serum magnesium is associated with faster decline in kidney function

T2 - The Dallas Heart Study experience

AU - Ferrè, Silvia

AU - Li, Xilong

AU - Huet, Beverley A

AU - Maalouf, Naim M

AU - Sakhaee, Khashayar

AU - Toto, Robert D

AU - Moe, Orson W

AU - Neyra, Javier A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline. We hypothesized that low serum magnesium (SMg) levels independently associate with a significant decline in estimated glomerular filtration rate (eGFR). We analyzed SMg levels in 2056 participants from the Dallas Heart Study, a longitudinal, population-based, multiethnic, cohort study involving residents of Dallas County, Texas, USA. The primary study outcome was the change in eGFR using multivariable linear regression models adjusted for demographics, anthropometric and biochemical parameters, medications, C reactive protein levels, prevalent hypertension and diabetes. During a median follow-up of 7.0 years (25th, 75th percentile: 6.5, 7.6), the median decrease in eGFR was '0.71 (25th, 75th percentile: '2.43, +0.68) mL/min/1.73 m 2 per year in the entire cohort. In a fully adjusted model, the lowest SMg quintile (≤1.9 mg/dL or ≤0.8 mM) was associated with a '0.50 mL/min/1.73 m 2 per year drop in eGFR (95% CI '0.95 to -0.05; p=0.028) compared with the highest SMg quintile (≥2.3 mg/dL or ≥1.0 mM). Every 0.2 mg/dL (0.08 mM) decrease in SMg was associated with an eGFR decline of '0.23 mL/min/1.73 m 2 per year (95% CI '0.38 to -0.08; p=0.003), a decline that was more pronounced in participants with prevalent diabetes compared with patients without diabetes ('0.51 vs '0.18 mL/min/1.73 m 2 per year, respectively). In conclusion, low SMg was independently associated with eGFR decline. Further studies are needed to determine whether Mg repletion can ameliorate inflammation, lower blood pressure and serum glucose and ultimately prevent or retard kidney function decline.

AB - Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline. We hypothesized that low serum magnesium (SMg) levels independently associate with a significant decline in estimated glomerular filtration rate (eGFR). We analyzed SMg levels in 2056 participants from the Dallas Heart Study, a longitudinal, population-based, multiethnic, cohort study involving residents of Dallas County, Texas, USA. The primary study outcome was the change in eGFR using multivariable linear regression models adjusted for demographics, anthropometric and biochemical parameters, medications, C reactive protein levels, prevalent hypertension and diabetes. During a median follow-up of 7.0 years (25th, 75th percentile: 6.5, 7.6), the median decrease in eGFR was '0.71 (25th, 75th percentile: '2.43, +0.68) mL/min/1.73 m 2 per year in the entire cohort. In a fully adjusted model, the lowest SMg quintile (≤1.9 mg/dL or ≤0.8 mM) was associated with a '0.50 mL/min/1.73 m 2 per year drop in eGFR (95% CI '0.95 to -0.05; p=0.028) compared with the highest SMg quintile (≥2.3 mg/dL or ≥1.0 mM). Every 0.2 mg/dL (0.08 mM) decrease in SMg was associated with an eGFR decline of '0.23 mL/min/1.73 m 2 per year (95% CI '0.38 to -0.08; p=0.003), a decline that was more pronounced in participants with prevalent diabetes compared with patients without diabetes ('0.51 vs '0.18 mL/min/1.73 m 2 per year, respectively). In conclusion, low SMg was independently associated with eGFR decline. Further studies are needed to determine whether Mg repletion can ameliorate inflammation, lower blood pressure and serum glucose and ultimately prevent or retard kidney function decline.

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