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接受定期血液透析的慢性肾病患儿的血清镁水平与血管硬度

Serum magnesium level and vascular stiffness in children with chronic kidney disease on regular hemodialysis.

作者信息

Zaher Manal Mohamed, Abdel-Salam Manal, Abdel-Salam Ragaa, Sabour Randa, Morsy Amal Abd El-Aleem, Gamal Dina

机构信息

Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

出版信息

Saudi J Kidney Dis Transpl. 2016 Mar;27(2):233-40. doi: 10.4103/1319-2442.178205.

Abstract

Chronic kidney disease (CKD) patients have a high prevalence of vascular calcifications, and cardiovascular disease is the leading cause of death in this population. Magnesium (Mg) depletion may be the missing link between multiple cardiovascular risk factors and the development of atherosclerosis. In this study, we aimed to assess the relationship between serum Mg levels and vascular stiffness in children with CKD on regular hemodialysis (HD). The study included 25 children with CKD on regular HD in our center; the study included also 25 healthy children age-and sex-matched as a control group. Serum Mg levels were measured, and Doppler ultrasound assessment of the intima-media thickness (IMT) and the peak systolic velocities (PSVs) of the main arteries including the (aorta, carotid, and femoral) arteries were recorded in the study patients. There were significantly lower serum Mg levels in children on regular HD than in the controls (1.7 ± 0.43 mg/dL vs. 2.31 ± 0.12 mg/dL, respectively, P = 0.001). There was a significant increase in the aorta and carotid IMT in the study group than in the controls (0.45 ± 0.07 mm vs. 0.40 ± 0.09 mm; 0.98 ± 0.57 mm vs. 0.55 ± 0.1 mm, P = 0.034 and 0.001, respectively), whereas there were no significant differences regarding the PSV of the carotid, aorta, and femoral arteries between the study patients and the controls (P >0.05). A negative correlation was found between serum Mg level with aortic IMT (AIMT) (r = -0.682; P = 0.000). In addition, a significant negative correlation was found between the AIMT with systolic and diastolic blood pressure (r = 0.447, P = 0.025, 0.472, P = 0.017), respectively. We conclude that lower serum Mg levels were associated with vascular calcification in chronic HD children. Confirmation of our results warrants further study.

摘要

慢性肾脏病(CKD)患者血管钙化的患病率很高,而心血管疾病是该人群的主要死因。镁(Mg)缺乏可能是多种心血管危险因素与动脉粥样硬化发展之间缺失的环节。在本研究中,我们旨在评估规律血液透析(HD)的CKD儿童血清镁水平与血管硬度之间的关系。该研究纳入了我们中心25例接受规律HD的CKD儿童;还纳入了25例年龄和性别匹配的健康儿童作为对照组。测定了血清镁水平,并记录了研究患者包括主动脉、颈动脉和股动脉在内的主要动脉的内膜中层厚度(IMT)和收缩期峰值流速(PSV)的多普勒超声评估结果。规律HD儿童的血清镁水平显著低于对照组(分别为1.7±0.43mg/dL和2.31±0.12mg/dL,P=0.001)。研究组主动脉和颈动脉IMT较对照组显著增加(分别为0.45±0.07mm对0.40±0.09mm;0.98±0.57mm对0.55±0.1mm,P分别为0.034和0.001),而研究患者与对照组之间颈动脉、主动脉和股动脉的PSV无显著差异(P>0.05)。血清镁水平与主动脉IMT(AIMT)之间呈负相关(r=-0.682;P=0.000)。此外,AIMT与收缩压和舒张压之间分别存在显著负相关(r=0.447,P=0.025;r=0.472,P=0.017)。我们得出结论,较低的血清镁水平与慢性HD儿童的血管钙化有关。对我们结果的证实值得进一步研究。

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