title: Results from the Atherosclerosis Risk in Communities study suggest that low serum magnesium is associated with incident kidney disease.
abstract: Low serum magnesium has been associated with kidney function decline in persons with diabetes as well as cardiovascular disease in the general population. As the association of serum magnesium with incident kidney disease in the general population is unknown, we assessed this in 13,226 participants (aged 45-65) in the Atherosclerosis Risk in Communities study with baseline estimated glomerular filtration rate of at least 60 ml/min per 1.73 m(2) in years 1987-89 and followed through 2010. The risks for incident chronic kidney disease (CKD) and end-stage renal disease (ESRD) associated with baseline total serum magnesium levels were evaluated using Cox regression. There were 1965 CKD and 208 ESRD events during a median follow-up of 21 years. In adjusted analysis, low serum magnesium levels (0.7 mmol/l or less) had significant associations with incident CKD and ESRD compared with the highest quartile with adjusted hazard ratio of 1.58 (95% CI: 1.35-1.87) for CKD and 2.39 (95% CI: 1.61-3.56) for ESRD. These associations remained significant after excluding users of diuretics and across subgroups stratified by hypertension, diabetes, and self-reported race. Thus, in a large sample of middle-aged adults, low total serum magnesium was independently associated with incident CKD and ESRD. Further studies are needed to determine whether modification of serum magnesium levels might alter subsequent incident kidney disease rates.
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Tin
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Morgan E
authors.initials: ME
authors.lastname: Grams
authors.affiliation: Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Nisa M
authors.initials: NM
authors.lastname: Maruthur
authors.affiliation: Department of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors.forename: Brad C
authors.initials: BC
authors.lastname: Astor
authors.affiliation: Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: David
authors.initials: D
authors.lastname: Couper
authors.affiliation: Geriatric Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Wen Hong Linda
authors.initials: WH
authors.lastname: Kao
mesh_terms: D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000097:blood* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D008274:Magnesium