肾移植受者中与他克莫司相关的低镁血症

Tacrolimus-associated hypomagnesemia in renal transplant recipients.

作者信息

Navaneethan S D, Sankarasubbaiyan S, Gross M D, Jeevanantham V, Monk R D

机构信息

Department of Internal Medicine, Unity Health System, Division of Nephrology, University of Rochester Medical Center, NY 14642, USA.

出版信息

Transplant Proc. 2006 Jun;38(5):1320-2. doi: 10.1016/j.transproceed.2006.02.077.

DOI:10.1016/j.transproceed.2006.02.077

PMID:16797291

Abstract

BACKGROUND

Since hypomagnesemia occurs frequently in tacrolimus treated patients, we studied the correlation between renal magnesium wasting and tacrolimus blood levels in renal transplant patients.

METHODS

Serum magnesium, fractional excretion of magnesium (FEMg), and 24-hour urinary excretion of magnesium were measured in 41 transplant patients and 10 healthy volunteers for correlation with tacrolimus level.

RESULTS

Of tacrolimus-treated patients, 43% displayed hypomagnesemia. FEMg (7.42+/-3.59% versus 1.88+/-0.43%) and 24-hour urinary excretion (112.36+/-51.43 mg/dL versus 6.7+/-2.79 mg/dL) were significantly higher among tacrolimus-treated patients than controls. Magnesium replacement did not influence FEMg or 24-hour urinary magnesium excretion. Tacrolimus level was the best predictor of 24-hour urinary magnesium excretion and FEMg. Serum magnesium levels correlated inversely with tacrolimus concentrations and creatinine clearance.

CONCLUSION

Hypomagnesemia in renal transplant recipients results from renal magnesium wasting. Tacrolimus levels and renal function impact on the excess renal magnesium excretion. Studies of longer duration are warranted to assess the long-term effects of this early posttransplant hypomagnesemia.

摘要

背景

由于他克莫司治疗的患者中低镁血症频繁发生，我们研究了肾移植患者肾镁排泄与他克莫司血药浓度之间的相关性。

方法

对41例移植患者和10名健康志愿者测定血清镁、镁排泄分数（FEMg）和24小时尿镁排泄量，以与他克莫司水平进行相关性分析。

结果

在接受他克莫司治疗的患者中，43%出现低镁血症。他克莫司治疗患者的FEMg（7.42±3.59%对1.88±0.43%）和24小时尿排泄量（112.36±51.43mg/dL对6.7±2.79mg/dL）显著高于对照组。补充镁对FEMg或24小时尿镁排泄无影响。他克莫司水平是24小时尿镁排泄和FEMg的最佳预测指标。血清镁水平与他克莫司浓度和肌酐清除率呈负相关。