title: Admission hypomagnesemia and hypermagnesemia increase the risk of acute kidney injury.
abstract: BACKGROUND
  The association between admission serum magnesium (Mg) levels and risk of in-hospital acute kidney injury (AKI) is limited. The aim of this study was to assess the risk of developing AKI in all hospitalized patients with various admission Mg levels.
  
  
  METHODS
  This is a single-center retrospective study conducted at a tertiary referral hospital. All hospitalized adult patients who had admission Mg available from January to December 2013 were analyzed in this study. Admission Mg was categorized based on its distribution into six groups (less than 1.5, 1.5-1.7, 1.7-1.9, 1.9-2.1, 2.1-2.3 and greater than 2.3 mg/dL). The primary outcome was in-hospital AKI occurring after hospital admission. Logistic regression analysis was performed to obtain the odds ratio of AKI of various admission Mg levels using Mg with lowest AKI incidence (1.9-2.1 mg/dL) as the reference group.
  
  
  RESULTS
  Of 9241 patients enrolled, AKI occurred in 1124 patients (12.2%). The lowest incidence of AKI was when serum Mg was within 1.7-1.9 and 1.9-2.1 mg/dL. A U-shaped curve emerged demonstrating higher incidences of AKI associated with both hypoMg (<1.7) and hyperMg (>2.1). After adjusting for potential confounders, both hypoMg (<1.5 mg/dL) and hyperMg (>2.3 mg/dL) were associated with an increased risk of developing AKI with odds ratios of 1.70 (95% CI 1.31-2.18) and 1.42 (95% CI 1.11-1.81), respectively.
  
  
  CONCLUSIONS
  Both admission hypoMg and hyperMg were associated with an increased risk for in-hospital AKI.
authors.affiliation: a Department of Medicine, Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA and.
authors.forename: Wisit
authors.initials: W
authors.lastname: Cheungpasitporn
authors.affiliation: a Department of Medicine, Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA and.|b Department of Anesthesiology , Mayo Clinic , Rochester , MN , USA.
authors.forename: Charat
authors.initials: C
authors.lastname: Thongprayoon
authors.affiliation: a Department of Medicine, Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA and.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Erickson
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology*; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers
chemical_list: D003404:Creatinine; D008274:Magnesium
keywords: Acute kidney injury; dysmagnesemia; electrolytes; hypermagnesemia; hypomagnesemia; magnesium