Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Amsterdam Cardiovascular Sciences, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands.
Nephrol Dial Transplant. 2022 Feb 25;37(3):421-429. doi: 10.1093/ndt/gfaa222.
Vascular calcification is a prognostic marker for cardiovascular mortality in chronic kidney disease (CKD) patients. In these patients, magnesium balance is disturbed, mainly due to limited ultrafiltration of this mineral, changes in dietary intake and the use of diuretics. Observational studies in dialysis patients report that a higher blood magnesium concentration is associated with reduced risk to develop vascular calcification. Magnesium prevents osteogenic vascular smooth muscle cell transdifferentiation in in vitro and in vivo models. In addition, recent studies show that magnesium prevents calciprotein particle maturation, which may be the mechanism underlying the anti-calcification properties of magnesium. Magnesium is an essential protective factor in the calcification milieu, which helps to restore the mineral-buffering system that is overwhelmed by phosphate in CKD patients. The recognition that magnesium is a modifier of calciprotein particle maturation and mineralization of the extracellular matrix renders it a promising novel clinical tool to treat vascular calcification in CKD. Consequently, the optimal serum magnesium concentration for patients with CKD may be higher than in the general population.
血管钙化是慢性肾脏病（CKD）患者心血管死亡率的预后标志物。在这些患者中，镁平衡受到干扰，主要是由于这种矿物质的超滤有限、饮食摄入变化和利尿剂的使用。在透析患者的观察性研究中报告称，较高的血液镁浓度与降低发生血管钙化的风险相关。镁可防止体外和体内模型中的成骨血管平滑肌细胞转分化。此外，最近的研究表明，镁可防止钙磷蛋白颗粒成熟，这可能是镁的抗钙化特性的机制。镁是钙化环境中的基本保护因素，有助于恢复因磷酸盐而超负荷的矿物质缓冲系统。镁是钙磷蛋白颗粒成熟和细胞外基质矿化的调节剂，这使其成为治疗 CKD 患者血管钙化的有前途的新型临床工具。因此，CKD 患者的最佳血清镁浓度可能高于一般人群。
