Wu Hongwei, Li Qiang, Fan Lijing, Zeng Dewang, Chi Xianggeng, Guan Baozhang, Hu Bo, Lu Yongping, Yun Chen, Krämer Bernhard, Hocher Berthold, Liu Fanna, Yin Lianghong
Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.
Department of Nephrology, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, China.
Kidney Dis (Basel). 2021 Jan;7(1):24-33. doi: 10.1159/000510513. Epub 2020 Nov 4.
Previous studies have reported that serum magnesium (Mg) deficiency is involved in the development of heart failure, particularly in patients with end-stage kidney disease. The association between serum Mg levels and mortality risk in patients receiving hemodialysis is controversial. We aimed to estimate the prognostic value of serum Mg concentration on all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.
We did a systematic literature search in PubMed, EMBASE, Cochrane Library, and Web of Science to identify eligible studies that reported the prognostic value of serum Mg levels in mortality risk among patients on hemodialysis. We performed a meta-analysis by pooling and analyzing hazard ratios (HRs) and 95% confidence intervals (CIs).
We identified 13 observational studies with an overall sample of 42,967 hemodialysis patients. Higher all-cause mortality (adjusted HR 1.58 [95% CI: 1.31-1.91]) and higher cardiovascular mortality (adjusted HR 3.08 [95% CI: 1.27-7.50]) were found in patients with lower serum Mg levels after multivariable adjustment. There was marked heterogeneity ( = 79.6%, < 0.001) that was partly explained by differences in age stratification and study area. In addition, subgroup analysis showed that a serum Mg concentration of ≤1.1 mmol/L might be the vigilant cutoff value.
A lower serum Mg level was associated with higher all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.
既往研究报道，血清镁（Mg）缺乏与心力衰竭的发生有关，尤其是在终末期肾病患者中。接受血液透析患者的血清镁水平与死亡风险之间的关联存在争议。我们旨在评估血清镁浓度对接受血液透析患者全因死亡率和心血管死亡率的预后价值。
我们在PubMed、EMBASE、Cochrane图书馆和Web of Science中进行了系统的文献检索，以确定报告血清镁水平对血液透析患者死亡风险预后价值的合格研究。我们通过汇总和分析风险比（HRs）及95%置信区间（CIs）进行了荟萃分析。
我们确定了13项观察性研究，总样本为42967例血液透析患者。多变量调整后，血清镁水平较低的患者全因死亡率较高（校正HR 1.58 [95% CI：1.31 - 1.91]），心血管死亡率较高（校正HR 3.08 [95% CI：1.27 - 7.50]）。存在明显的异质性（I² = 79.6%，P < 0.001），部分原因是年龄分层和研究区域的差异。此外，亚组分析表明，血清镁浓度≤1.1 mmol/L可能是一个警戒临界值。
接受血液透析患者的血清镁水平较低与全因死亡率和心血管死亡率较高相关。
