Division of Nephrology, Department of Internal Medicine, Medical University of Graz, A-8036 Graz, Austria.
Transplant Center Graz, Medical University of Graz, A-8036 Graz, Austria.
Nutrients. 2021 Apr 14;13(4):1296. doi: 10.3390/nu13041296.
Magnesium (Mg) deficiency is a common finding in the early phase after kidney transplantation (KT) and has been linked to immune dysfunction and infections. Data on the association of hypomagnesemia and the rate of infections in kidney transplant recipients (KTRs) are sparse.
We conducted a single-center retrospective cohort study of KTRs transplanted between 2005 and 2015. Laboratory data, including serum Mg (median time of the Mg measurement from KT: 29 days), rate of infections including mainly urinary tract infections (UTI), and common transplant-related viral infections (CMV, polyoma, EBV) in the early phase after KT were recorded. The primary outcome was the incidence of infections within one year after KT, while secondary outcomes were hospitalization due to infection, incidence rates of long-term (up to two years) infections, and all-cause mortality.
We enrolled 376 KTRs of whom 229 patients (60.9%) suffered from Mg deficiency defined as a serum Mg < 0.7 mmol/L. A significantly higher incidence rate of UTIs and viral infections was observed in patients with versus without Mg deficiency during the first year after KT (58.5% vs. 47.6%, 0.039 and 69.9% vs. 51.7%, < 0.001). After adjustment for potential confounders, serum Mg deficiency remained an independent predictor of both UTIs and viral infections (odds ratio (OR): 1.73, 95% CI: 1.04-2.86, = 0.035 and OR: 2.05, 95% CI: 1.23-3.41, = 0.006). No group differences according to Mg status in hospitalizations due to infections and infection incidence rates in the 12-24 months post-transplant were observed. In the Cox regression analysis, Mg deficiency was not significantly associated with all-cause mortality (HR: 1.15, 95% CI: 0.70-1.89, = 0.577).
KTRs suffering from Mg deficiency are at increased risk of UTIs and viral infections in the first year after KT. Interventional studies investigating the effect of Mg supplementation on Mg deficiency and viral infections in KTRs are needed.
镁（Mg）缺乏在肾移植（KT）后早期很常见，与免疫功能障碍和感染有关。关于低镁血症与肾移植受者（KTR）感染率之间的关联的数据很少。
我们进行了一项单中心回顾性队列研究，纳入了 2005 年至 2015 年间接受 KT 的 KTR。记录了实验室数据，包括血清 Mg（从 KT 到测量 Mg 的中位数时间：29 天）、感染率，包括主要的尿路感染（UTI），以及 KT 后早期的常见移植相关病毒感染（CMV、多瘤病毒、EBV）。主要结局是 KT 后 1 年内的感染发生率，次要结局是因感染而住院、长期（长达 2 年）感染的发生率以及全因死亡率。
我们纳入了 376 名 KTR，其中 229 名患者（60.9%）存在血清 Mg < 0.7 mmol/L 的镁缺乏症。在 KT 后 1 年内，与无镁缺乏症的患者相比，患有镁缺乏症的患者 UTI 和病毒感染的发生率显著更高（58.5%比 47.6%，0.039 和 69.9%比 51.7%，< 0.001）。在校正了潜在的混杂因素后，血清 Mg 缺乏症仍然是 UTI 和病毒感染的独立预测因素（优势比（OR）：1.73，95%置信区间（CI）：1.04-2.86，= 0.035 和 OR：2.05，95% CI：1.23-3.41，= 0.006）。根据镁状态，在感染相关住院和移植后 12-24 个月的感染发生率方面，两组间无差异。在 Cox 回归分析中，镁缺乏症与全因死亡率无显著相关性（HR：1.15，95% CI：0.70-1.89，= 0.577）。
患有镁缺乏症的 KTR 在 KT 后 1 年内发生 UTI 和病毒感染的风险增加。需要进行干预性研究，以评估镁补充对 KTR 镁缺乏症和病毒感染的影响。
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