Turgut Faruk, Kanbay Mehmet, Metin Melike Rusen, Uz Ebru, Akcay Ali, Covic Adrian
Department of Internal Medicine, Section of Nephrology, Fatih University School of Medicine, Hosdere cad no:145, Y. Ayranci, 06540, Ankara, Turkey.
Int Urol Nephrol. 2008;40(4):1075-82. doi: 10.1007/s11255-008-9410-3. Epub 2008 Jun 21.
The atherosclerotic process progresses more dynamically in hemodialysis (HD) patients than in the general population. In HD patients, lower magnesium levels were reported to be associated with increased atherosclerosis of the common carotid artery. We tested the hypotheses that magnesium supplementation helps to improve carotid intima media thickness (IMT) in HD patients.
A total of 47 patients on HD were included in the study. Patients were randomly divided into two groups: group A (Mg group), in which patients were given magnesium citrate orally at a dosage of 610 mg every other day for 2 months and group B (control group), in which patients received only calcium acetate therapy as a phosphate binder. At baseline and 2 months later, all patients underwent a carotid artery ultrasound scan to measure carotid IMT.
At the end of 2 months, mean serum calcium, phosphorus, and calcium x phosphorus product were not changed in both groups. As expected, mean serum Mg level significantly increased in the Mg group at the end of 2 months. In addition, serum parathyroid hormone (PTH) level significantly decreased in the Mg group at the end of 2 months (P = 0.003). Baseline carotid IMT was similar between the groups. Bilateral carotid IMT was significantly improved in patients treated with magnesium citrate compared to initial values (P = 0.001 for left, P = 0.002 for right).
Based on the present data, magnesium may play an important protective role in the progression of atherosclerosis in patients on dialysis. Further studies are needed to assess more accurately the role of magnesium in atherosclerotic regression in dialysis patients.
动脉粥样硬化进程在血液透析（HD）患者中比在普通人群中进展更为动态。在HD患者中，据报道较低的镁水平与颈总动脉粥样硬化增加有关。我们检验了补充镁有助于改善HD患者颈动脉内膜中层厚度（IMT）的假设。
本研究共纳入47例HD患者。患者被随机分为两组：A组（镁组），患者每隔一天口服610mg柠檬酸镁，持续2个月；B组（对照组），患者仅接受醋酸钙治疗作为磷结合剂。在基线和2个月后，所有患者均接受颈动脉超声扫描以测量颈动脉IMT。
2个月末，两组患者的平均血清钙、磷及钙磷乘积均未改变。正如预期的那样，2个月末镁组的平均血清镁水平显著升高。此外，2个月末镁组的血清甲状旁腺激素（PTH）水平显著降低（P = 0.003）。两组间基线颈动脉IMT相似。与初始值相比，接受柠檬酸镁治疗的患者双侧颈动脉IMT均显著改善（左侧P = 0.001，右侧P = 0.002）。
基于目前的数据，镁可能在透析患者动脉粥样硬化进展中发挥重要的保护作用。需要进一步研究以更准确地评估镁在透析患者动脉粥样硬化消退中的作用。
