Magnesium in Chronic Kidney Disease: Should We Care?

Blood Purif. 2018;45(1-3):173-178. doi: 10.1159/000485212. Epub 2018 Jan 26.

Abstract

Background: Magnesium (Mg) is an essential cation for multiple processes in the body. The kidney plays a major role in regulating the Mg balance. In a healthy individual, total-body Mg content is kept constant by interactions among intestine, bones and the kidneys.

Summary: In case of chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal Mg absorption. Usually Mg remains normal; however, when glomerular filtration rate declines, changes in serum Mg are observed. Patients with end-stage renal disease on dialysis are largely dependent on the dialysate Mg concentration for maintaining serum Mg and Mg homeostasis. A low Mg is associated with several complications such as hypertension, and vascular calcification, and also associated with an increased risk for both cardiovascular disease (CVD) and non-CVD mortality. Severe hypermagnesaemia is known to cause cardiac conduction defects, neuromuscular effects and muscle weakness; a slightly elevated Mg has been suggested to be beneficial in patients with end-stage renal disease. Key Messages: The role of both low and high Mg, in general, but especially in relation to CKD and dialysis patients is discussed.

Keywords: (Patho) physiology; Chronic kidney disease; Haemodialysis; Magnesium; Outcome.

Publication types

  • Review

MeSH terms

  • Cardiac Conduction System Disease / blood*
  • Cardiac Conduction System Disease / etiology
  • Cardiac Conduction System Disease / physiopathology
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / blood*
  • Hypertension / etiology
  • Hypertension / physiopathology
  • Kidney / metabolism*
  • Kidney / pathology
  • Kidney / physiopathology
  • Kidney Failure, Chronic / blood*
  • Kidney Failure, Chronic / pathology
  • Kidney Failure, Chronic / physiopathology
  • Magnesium / blood*
  • Muscle Weakness / blood*
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology
  • Renal Dialysis / adverse effects*
  • Vascular Calcification / blood*
  • Vascular Calcification / etiology
  • Vascular Calcification / physiopathology

Substances

  • Magnesium