Truttmann Anita C, Faraone Rita, Von Vigier Rodo O, Nuoffer Jean Marc, Pfister Roger, Bianchetti Mario G
Inselspital, University of Berne, Switzerland.
Nephron. 2002;92(3):616-21. doi: 10.1159/000064109.
Circulating magnesium exists in the bound and in the free ionized form, that is biologically active. In kidney disease the relationship between ionized and total circulating magnesium is often altered. Little information is available on the influence of hemodialysis on the relationship between ionized and total circulating magnesium in end-stage kidney disease.
Plasma total and ionized magnesium and the plasma ionized magnesium fraction were assessed before and after hemodialysis (dialysate magnesium content 0.75 mmol/l) in 46 patients with end-stage kidney disease and in a control group of 25 healthy subjects.
In patients plasma total (from 1.19 [1.05-1.33] to 1.10 [1.02-1.16] mmol/l; median and interquartile range) and ionized (from 0.71 [0.66-0.78] to 0.65 [0.63-0.69] mmol/l) magnesium significantly decreased during dialysis (control subjects: 0.82 [0.80-0.92], respectively, 0.57 [0.54-0.59] mmol/l). The plasma ionized magnesium fraction was significantly lower in patients both before (0.61 [0.58-0.64)] and after (0.60 [0.56-0.62]) hemodialysis than in controls (0.68 [0.65-0.70]).
The study demonstrates a tendency towards a reduced circulating ionized magnesium fraction in end-stage kidney disease that is not corrected by hemodialysis.
循环镁以结合形式和游离离子形式存在，其中游离离子形式具有生物活性。在肾脏疾病中，离子化镁与循环总镁之间的关系常常发生改变。关于血液透析对终末期肾病患者离子化镁与循环总镁之间关系的影响，目前所知甚少。
对46例终末期肾病患者和25名健康对照者在血液透析前后（透析液镁含量0.75 mmol/L）评估血浆总镁和离子化镁以及血浆离子化镁分数。
患者在透析期间血浆总镁（从1.19 [1.05 - 1.33]降至1.10 [1.02 - 1.16] mmol/L；中位数和四分位数间距）和离子化镁（从0.71 [0.66 - 0.78]降至0.65 [0.63 - 0.69] mmol/L）显著降低（对照者分别为0.82 [0.80 - 0.92]和0.57 [0.54 - 0.59] mmol/L）。患者在血液透析前（0.61 [0.58 - 0.64]）和后（0.60 [0.56 - 0.62]）的血浆离子化镁分数均显著低于对照者（0.68 [0.65 - 0.70]）。
该研究表明终末期肾病患者循环离子化镁分数有降低的趋势，且血液透析无法纠正这一趋势。
