title: Hypomagnesemia in type 2 diabetic nephropathy: a novel predictor of end-stage renal disease.
abstract: OBJECTIVE
  There is now growing evidence that magnesium (Mg) deficiency is implicated in type 2 diabetes and its complications. However, it has not been fully elucidated whether hypomagnesemia is a predictor of end-stage renal disease (ESRD) in type 2 diabetic nephropathy.
  
  
  METHODS
  This retrospective cohort study included 455 chronic kidney disease (CKD) patients (144 with type 2 diabetic nephropathy and 311 with nondiabetic CKD) who were hospitalized at Osaka General Medical Center for a CKD educational program between April 2001 and December 2007. The primary outcome was progression to renal replacement therapy. Participants were categorized based on serum Mg level into Low-Mg (serum Mg level ≤1.8 mg/dL) and High-Mg (serum Mg level >1.8 mg/dL) groups with the previously published normal lower limit chosen as the cutoff point.
  
  
  RESULTS
  Of the subjects with type 2 diabetic nephropathy, 102 progressed to ESRD during follow-up (median, 23 months). A multivariate Cox proportional hazards model showed that after adjustment for various demographic factors and laboratory data, the Low-Mg group had a 2.12-fold higher risk of ESRD than the High-Mg group (95% CI 1.28-3.51; P = 0.004). In contrast, 135 of the nondiabetic CKD subjects progressed to ESRD during follow-up (median, 44 months). No significant difference in outcome was found between the Low- and High-Mg groups of this population (adjusted hazard ratio, 1.15; 95% CI 0.70-1.90; P = 0.57).
  
  
  CONCLUSIONS
  Hypomagnesemia is a novel predictor of ESRD in patients with type 2 diabetic nephropathy.
authors.affiliation: Department of Kidney Disease and Hypertension, Osaka General Medical Center, Osaka, Japan. yusuke7771@gmail.com
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Shoji
authors.forename: Terumasa
authors.initials: T
authors.lastname: Hayashi
authors.forename: Akira
authors.initials: A
authors.lastname: Suzuki
authors.forename: Morihiro
authors.initials: M
authors.lastname: Shimizu
authors.forename: Kensuke
authors.initials: K
authors.lastname: Mitsumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawabata
authors.forename: Kakuya
authors.initials: K
authors.lastname: Niihata
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Okada
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Isaka
authors.forename: Hiromi
authors.initials: H
authors.lastname: Rakugi
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Tsubakihara
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000150:complications*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D008274:Magnesium