Ortega Olimpia, Rodriguez Isabel, Cobo Gabriela, Hinostroza Julie, Gallar Paloma, Mon Carmen, Ortiz Milagros, Herrero Juan Carlos, Di Gioia Cristina, Oliet Aniana, Vigil Ana
Nephrology Service, Hospital Severo Ochoa, Avenida Orellana s/n, Leganés 28911, Madrid, Spain.
ISRN Nephrol. 2013 Jun 19;2013:191786. doi: 10.5402/2013/191786. eCollection 2013.
Background. Low serum magnesium has been associated with an increased cardiovascular risk in the general population and in dialysis patients. Our aim was to analyze the influence of serum magnesium on overall mortality and cardiovascular outcomes in patients with advanced CKD not yet on dialysis. Methods. Seventy patients with CKD stages 4 and 5 were included. After a single measurement of s-magnesium, patients were followed a mean of 11 months. Primary end-point was death of any cause, and secondary end-point was the occurrence of fatal or nonfatal CV events. Results. Basal s-magnesium was within normal range (2.1 ± 0.3 mg/dL), was lower in men (P = 0.008) and in diabetic patients (P = 0.02), and was not different (P = 0.2) between patients with and without cardiopathy. Magnesium did not correlate with PTH, calcium, phosphate, albumin, inflammatory parameters (CRP), and cardiac (NT-proBNP) biomarkers but correlated inversely (r = -0.23; P = 0.052) with the daily dose of loop diuretics. In univariate and multivariate Cox proportional hazard models, magnesium was not an independent predictor for overall mortality or CV events. Conclusions. Our results do not support that serum magnesium can be an independent predictor for overall mortality or future cardiovascular events among patients with advanced CKD not yet on dialysis.
背景。低血清镁与普通人群及透析患者心血管风险增加相关。我们的目的是分析血清镁对尚未接受透析的晚期慢性肾脏病（CKD）患者全因死亡率和心血管结局的影响。方法。纳入70例CKD 4期和5期患者。单次测量血清镁后，对患者平均随访11个月。主要终点是任何原因导致的死亡，次要终点是致命或非致命心血管事件的发生。结果。基础血清镁在正常范围内（2.1±0.3mg/dL），男性（P = 0.008）和糖尿病患者（P = 0.02）的血清镁较低，有心脏病和无心脏病患者之间无差异（P = 0.2）。镁与甲状旁腺激素、钙、磷、白蛋白、炎症参数（CRP）及心脏（NT-proBNP）生物标志物均无相关性，但与襻利尿剂的每日剂量呈负相关（r = -0.23；P = 0.052）。在单因素和多因素Cox比例风险模型中，镁不是全因死亡率或心血管事件的独立预测因素。结论。我们的结果不支持血清镁可作为尚未接受透析的晚期CKD患者全因死亡率或未来心血管事件的独立预测因素。
