Massy Ziad A, Nistor Ionut, Apetrii Mugurel, Brandenburg Vincent M, Bover Jordi, Evenepoel Pieter, Goldsmith David, Mazzaferro Sandro, Urena-Torres Pablo, Vervloet Marc G, Cozzolino Mario, Covic Adrian, Era-Edta On Behalf Of Ckd-Mbd Working Group Of
Division of Nephrology, Ambroise Paré Universty Hospital, University of Paris Ouest - Versailles-Saint-Quentin-en-Yvelines (UVSQ), Boulogne Billancourt/ Paris, and Inserm U-1018, Centre de recherche en épidémiologie et santé des populations (CESP), Equipe 5, Villejuif, France.
Nephrology Department, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania, ERBP, Ghent University Hospital, Ghent, Belgium.
Magnes Res. 2016 Apr 1;29(4):126-140. doi: 10.1684/mrh.2016.0412.
Magnesium (Mg) is one of the most important cations in the body, playing an essential role in biological systems as co-factor for more than 300 essential enzymatic reactions. In the general population, low levels of Mg are associated with a high risk of cardio-vascular disease (CVD). Despite the accumulating literature data, the effect of Mg administration on mortality in chronic kidney disease (CKD) patients has never been investigated as a primary end-point. We conducted a systematic search of studies assessing the benefits and harms of Mg in CKD (stages 1 to 5 and 5D), and considered all randomized controlled trials (RCTs) and quasi-RCTs evaluating Mg-based interventions in CKD. As a phosphate binder, Mg salts offer a plausible opportunity for doubly favorable effects via reduction of intestinal phosphate absorption and addition of potentially beneficial effects via increasing circulating Mg levels. Mg supplementation might have a favorable effect on vascular calcification, although evidence for this is very slight. Although longitudinal data describe an association between low serum Mg levels and increased total and cardiovascular mortality, in patients with CKD, the existing RCTs reporting the effect of Mg supplementation on mortality failed to demonstrate any favorable effect. As with many other variables that influence hard end-points in nephrology, the role of Mg in CKD patients needs to be investigated in more depth. Additional research that is well-designed and directly targeting the role of Mg is needed as a consequence of limited existing evidence.
镁（Mg）是人体中最重要的阳离子之一，作为300多种重要酶促反应的辅助因子，在生物系统中发挥着至关重要的作用。在普通人群中，低镁水平与心血管疾病（CVD）的高风险相关。尽管有越来越多的文献数据，但镁给药对慢性肾脏病（CKD）患者死亡率的影响从未作为主要终点进行过研究。我们对评估镁在CKD（1至5期和5D期）中的益处和危害的研究进行了系统检索，并纳入了所有评估基于镁的干预措施对CKD影响的随机对照试验（RCT）和准RCT。作为一种磷结合剂，镁盐通过减少肠道磷吸收以及通过提高循环镁水平增加潜在有益作用，提供了产生双重有利影响的合理机会。补充镁可能对血管钙化有有利影响，尽管这方面的证据非常少。虽然纵向数据描述了低血清镁水平与总死亡率和心血管死亡率增加之间的关联，但在CKD患者中，现有的报告补充镁对死亡率影响的RCT未能证明有任何有利影响。与许多其他影响肾脏病硬终点的变量一样，镁在CKD患者中的作用需要更深入地研究。由于现有证据有限，因此需要设计良好且直接针对镁作用的进一步研究。
