Lahav Itay, Steinmetz Tali, Molcho Maya, Lev Neta, Agur Timna, Nesher Eviatar, Rozen-Zvi Benaya, Rahamimov Ruth
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Nephrology, Rabin Medical Center, Petah Tikva, Israel.
Front Med (Lausanne). 2021 Jul 12;8:690273. doi: 10.3389/fmed.2021.690273. eCollection 2021.
Serum magnesium levels are associated with cardiovascular disease and all-cause mortality in the general population and chronic kidney disease patients, but the association between serum magnesium levels and cardiovascular risk after kidney transplantation is not established. We sought to evaluate whether exposure to low serum magnesium levels after renal transplantation is related to cardiovascular morbidity and mortality. We conducted a single center retrospective study that included all transplanted patients who had a functioning graft for at least 6 months after transplantation between January 2001 and December 2013. We calculated exposure to magnesium using time weighted average for serum magnesium levels, using all values available during the follow-up. Several statistical methods were used, including liner regression analysis, χ test, and multivariate Cox proportional hazard model. Four hundred ninety-eight patients were included. Median follow-up was 5.26 years. High time weighted average of serum magnesium was associated with a hazard ratio of 1.94 for all-cause mortality and major cardiovascular outcome compared to low levels (95% CI 1.18-3.19, = 0.009). The high quartile of time weighted average of serum magnesium was associated with death censored major cardiovascular outcome (hazard ratio 2.13, 95% CI 1.17-3.86, = 0.013) in multivariate analysis. Exposure to low serum magnesium levels in renal transplant recipients was associated with a lower risk for all-cause mortality and major cardiovascular outcome. These findings contrast the higher risk found in the general population.
血清镁水平与普通人群及慢性肾病患者的心血管疾病和全因死亡率相关，但肾移植后血清镁水平与心血管风险之间的关联尚未确立。我们试图评估肾移植后血清镁水平低是否与心血管发病率和死亡率相关。我们进行了一项单中心回顾性研究，纳入了2001年1月至2013年12月期间所有移植后至少有一个功能良好的移植物达6个月的患者。我们使用随访期间所有可用值的时间加权平均值来计算镁暴露量。使用了几种统计方法，包括线性回归分析、χ检验和多变量Cox比例风险模型。共纳入498例患者。中位随访时间为5.26年。与低水平相比，血清镁的高时间加权平均值与全因死亡率和主要心血管结局的风险比为1.94（95%CI 1.18 - 3.19，P = 0.009）。在多变量分析中，血清镁时间加权平均值的高四分位数与死亡删失的主要心血管结局相关（风险比2.13，95%CI 1.17 - 3.86，P = 0.013）。肾移植受者血清镁水平低与全因死亡率和主要心血管结局风险较低相关。这些发现与普通人群中发现的较高风险形成对比。
