Chacar Fernanda Chicharo, Kogika Marcia Mery, Ferreira Andréa C, Kanayama Khadine K, Reche Archivaldo
Internal Medicine, School of Veterinary Medicine and Animal Science/University of Sao Paulo, Sao Paulo, Brazil.
J Feline Med Surg. 2019 Dec;21(12):1172-1180. doi: 10.1177/1098612X18823588. Epub 2019 Jan 29.
Magnesium has been 'the forgotten ion' for many years. Over the past decade, however, the role of magnesium in essential physiological functions and several illness conditions have been elucidated. Nevertheless, the investigation of magnesium in cats with chronic kidney disease (CKD) and nephrolithiasis is yet to be determined. The purpose of this study was to investigate whether CKD cats with nephrolithiasis have changes in total serum magnesium concentrations, and whether magnesium disorders may be associated with other electrolyte disturbances, as well as with prognosis. We also aimed to evaluate whether total serum magnesium concentration differs between CKD cats with and without nephrolithiasis.
Total serum magnesium concentrations were assessed in 42 cats with CKD with stage 1-4 nephrolithiasis. The correlation between magnesium and other electrolytes, as well as Kaplan-Meier survival analysis, were performed. We also selected 14 control cats with CKD without nephrolithiasis age-matched with 14 cats with CKD with nephrolithiasis.
Hypermagnesemia was observed in 16/42 (38.1%) and hypomagnesemia in 6/42 (14.3%) cats. Serum magnesium abnormalities were observed in cats of all stages, and marked hypermagnesemia was noted in cats with stage 4 CKD with nephrolithiasis ( <0.001). There was a negative correlation between total serum magnesium and ionized calcium ( = -0.64; <0.01), and a positive correlation between total serum magnesium and serum phosphorus ( = 0.58, = 0.01). Cats with CKD with nephrolithiasis and hypomagnesemia or hypermagnesemia had higher mortality than those with normal total serum magnesium concentration ( <0.01), regardless of CKD stage. There was no difference in total serum magnesium concentration between CKD cats with and without nephrolithiasis.
Cats with CKD with nephrolithiasis have magnesium abnormalities. Hypomagnesemia and hypermagnesemia were associated with an increase in mortality, and thus total serum magnesium abnormalities may be used as prognostic factors in these cases.
多年来镁一直是“被遗忘的离子”。然而，在过去十年中，镁在基本生理功能和多种疾病状态中的作用已得到阐明。尽管如此，对于患有慢性肾病（CKD）和肾结石的猫体内镁的研究仍有待确定。本研究的目的是调查患有肾结石的CKD猫的血清总镁浓度是否有变化，以及镁紊乱是否可能与其他电解质紊乱以及预后相关。我们还旨在评估患有和未患有肾结石的CKD猫之间血清总镁浓度是否存在差异。
对42只患有1 - 4期肾结石的CKD猫进行血清总镁浓度评估。进行了镁与其他电解质之间的相关性分析以及Kaplan - Meier生存分析。我们还选择了14只无肾结石的CKD对照猫，其年龄与14只患有肾结石的CKD猫相匹配。
在42只猫中，16只（38.1%）出现高镁血症，6只（14.3%）出现低镁血症。在所有阶段的猫中均观察到血清镁异常，在患有4期CKD和肾结石的猫中观察到明显的高镁血症（<0.001）。血清总镁与离子钙之间呈负相关（= -0.64；<0.01），血清总镁与血清磷之间呈正相关（= 0.58，= 0.01）。无论CKD处于何阶段，患有肾结石且伴有低镁血症或高镁血症的CKD猫的死亡率均高于血清总镁浓度正常的猫（<0.01）。患有和未患有肾结石的CKD猫之间血清总镁浓度无差异。
患有肾结石的CKD猫存在镁异常。低镁血症和高镁血症与死亡率增加相关，因此血清总镁异常可作为这些病例的预后因素。
