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Table 2 Observational studies examining the relationship between serum Mg levels and mortality

From: Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions

Authors (year)

Subjects

Dialysis duration

Dialysate Mg (mmol/L)

Follow-up period

Adjusted HR

Adjustments

Pre-dialysis CKD

 Van Laecke et al. (2013) [12]

1650

–

–

Median 5.1 years

All-cause mortality 0.930 per 0.1-mg/dL increase in serum Mg levels

All-cause mortality 1.613 in the low Mg group (< 1.8 mg/dL) vs. the high Mg group (> 2.2 mg/dL)

Age, sex, DM, hypertension, obesity, smoking, eGFR, diuretics, RAAS blockade, UA, Na, K, P, CRP

Dialysis

 Sakaguchi et al. (2014) [69]

142,555, HD

Median 7 years

0.5

1 year

All-cause mortality 1.28, cardiovascular mortality 1.24, non-cardiovascular mortality 1.32 in the lowest Mg sextile (< 2.3 mg/dL) vs. the second highest sextile (≥ 2.8, < 3.1 mg/dL)

Age, sex, HD duration, weekly HD time, BMI, DM, CVD, parathyroidectomy, hip fracture, BUN, albumin, ALP, hemoglobin, Ca, P, CRP, iPTH, VDRAs, PBs, cinacalcet

 Kurita et al. (2015) [70]

2165, HD

Median 8.3 years

0.5

3 years

All-cause mortality 1.734 in the lowest Mg quintile (≤ 2.3 mg/dL) vs. the middle quintile (> 2.5, ≤ 2.7 mg/dL)

All-cause mortality 1.649 in the second lowest quintile (> 2.3, ≤ 2.5 mg/dL) vs.the middle quintile

Age, sex, HD duration, Kt/V, primary renal disease, BMI, CVD, lung disease, liver disease, malignancy, parathyroidectomy, albumin, hemoglobin, K, Ca, P, CRP, iPTH, serum iron, ferritin

 de Roji van Zuijdewijn et al. (2015) [71]

HD 184, HDF 181

Median 1.8 years

0.5

Mean 3.1 years

All-cause mortality 0.88, cardiovascular mortality 0.73, sudden death 0.78 per 0.1-mmol/L (0.24 mg/dL) increase in serum Mg levels

Age, sex, HD duration, weekly HD time, dialysis modality (HD/HDF), residual renal function, BMI, BP, DM, CVD, albumin, Ca, P, iPTH

 Lacson et al. (2015) [33]

27,544, HD

Median 2.5 years

Various

1 year

All-cause mortality 0.89 in the highest Mg group (≥ 1.25 mmol/L) vs. the reference group (≥ 0.80, < 0.95 mmol/L) (not significant)

Case mix: age, sex, race/ethnicity, HD duration, vascular access type, BSA

Laboratory: Kt/V, DM, albumin, hemoglobin, Ca, P, iPTH

 Li et al. (2015) [34]

9359, HD

Incident patients

Not mentioned

Mean 19 months

No relationship between time-varying serum Mg levels and all-cause mortality after all adjustments

Age, sex, race/ethnicity, Kt/V, BMI, DM, hypertension, dyslipidemia, CVD, lung disease, liver disease, cancer, BUN, albumin, ALP, hemoglobin, K, Ca, P, iPTH, ferritin, nPCR

 Cai et al. (2016) [35]

253, PD

Incident patients

0.25

Median 29 months

All-cause mortality 0.075 in the normomagnesemia group (≥ 1.7 mg/dL) vs. the hypomagnesemia group (< 1.7 mg/dL)

Cardiovascular mortality 0.003 in the normomagnesemia group vs. the hypomagnesemia group

Age, sex, BMI, DM, BP, urine output, net UF, weekly Ccr, residual renal function, albumin, total cholesterol, triglycerides, hemoglobin, Na, Ca, P, iPTH, calcium carbonate, VDRAs

 Yang et al. (2016) [72]

10,692, PD

Incident patients

Not mentioned

Median 13 months

Hospitalization risk 1.09 in the lowest Mg quintile (< 1.8 mg/dL) vs. the middle quintile (≥ 2.0, < 2.2 mg/dL)

All-cause mortality 0.97 in the lowest Mg quintile vs. the middle quintile (not significant)

Age, sex, race/ethnicity, primary insurance, primary renal disease, total weekly Kt/V, residual renal function, 4-h D/P Cr ratio, DM, hypertension, CVD, albumin, hemoglobin, K, Ca, P, bicarbonate, iPTH, ferritin, iron saturation

  1. Abbreviations: 4-h D/P Cr ratio 4-h dialysate to plasma creatinine ratio from the peritoneal equilibration test, ALP alkaline phosphatase, BMI body mass index, BP blood pressure, BUN blood urea nitrogen, BSA body surface area, Ccr creatinine clearance, CKD chronic kidney disease, CRP C-reactive protein, CVD cardiovascular disease, DM diabetes mellitus, eGFR estimated glomerular filtration rate, HD hemodialysis, HDF hemodiafiltration, HR hazard ratio, iPTH intact parathyroid hormone, nPCR normalized protein catabolic rate, PBs phosphate binders, PD peritoneal dialysis, RAAS renin-angiotensin-aldosterone system, UA uric acid, UF ultrafiltration, VDRAs vitamin D receptor agonists