Zhao Jing, Lin Xuechun, Wang Jinxue, Guo Xiaolei, Peng Fan, Zuo Xuezhi, Tian Chong, Ying Chenjiang
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Clinical Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Biol Trace Elem Res. 2024 Oct 30. doi: 10.1007/s12011-024-04432-w.
The association between serum magnesium and residual renal function (RRF) among peritoneal dialysis (PD) patients remains unclear. The present study examined the relationships between serum magnesium and the risk of anuria in patients receiving continuous ambulatory peritoneal dialysis (CAPD). This prospective cohort study included 261 PD patients in China. All participants received CAPD for more than 3 months between 2012 and December 2022. Loss of RRF (anuria) was characterized by a 24-h urine output below 100 ml. Cox proportional hazard regression models and competing risk models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of anuria across different serum magnesium levels. During the median follow-up of 21.3 (15.0-32.4) months, 130 individuals progressed to anuria. The mean concentration of serum magnesium was 0.9 ± 0.15 mmol/L. After multivariate adjustment, the association of serum magnesium with the risk of anuria was not significant in the entire study population. However, for PD patients with better preservation of RRF, the risk of anuria decreases significantly as serum magnesium increases (HR for per standard deviation increment 0.53, 95% CI 0.32-0.88). The protective effect of increased serum magnesium concentrations on RRF was more pronounced among PD patients with lower triglyceride glucose (TyG) index at baseline compared to those with higher TyG index (p for interaction = 0.03). Our results indicated that higher serum magnesium predicts better renal prognosis for PD patients with better preservation of RRF. Levels of TyG index may modulate the relationship.
腹膜透析（PD）患者血清镁与残余肾功能（RRF）之间的关联尚不清楚。本研究探讨了接受持续性非卧床腹膜透析（CAPD）患者血清镁与无尿风险之间的关系。这项前瞻性队列研究纳入了261名中国的PD患者。所有参与者在2012年至2022年12月期间接受CAPD治疗超过3个月。RRF丧失（无尿）的特征是24小时尿量低于100毫升。使用Cox比例风险回归模型和竞争风险模型来估计不同血清镁水平下无尿风险的风险比（HR）和95%置信区间（CI）。在中位随访21.3（15.0 - 32.4）个月期间，130人进展为无尿。血清镁的平均浓度为0.9±0.15毫摩尔/升。多变量调整后，血清镁与无尿风险之间的关联在整个研究人群中不显著。然而，对于RRF保存较好的PD患者，随着血清镁升高，无尿风险显著降低（每标准差增加的HR为0.53，95% CI为0.32 - 0.88）。与基线甘油三酯葡萄糖（TyG）指数较高的患者相比，血清镁浓度升高对RRF的保护作用在基线TyG指数较低的PD患者中更为明显（交互作用p = 0.03）。我们的结果表明，较高的血清镁预示着RRF保存较好的PD患者有更好的肾脏预后。TyG指数水平可能调节这种关系。
