title: Hypomagnesemia Is Associated with Increased Mortality among Peritoneal Dialysis Patients.
abstract: OBJECTIVE
  Hypomagnesemia has been associated with an increase in mortality among the general population as well as patients with chronic kidney disease or those on hemodialysis. However, this association has not been thoroughly studied in patients undergoing peritoneal dialysis. The aim of this study was to evaluate the association between serum magnesium concentrations and all-cause and cardiovascular mortalities in peritoneal dialysis patients.
  
  
  METHODS
  This single-center retrospective study included 253 incident peritoneal dialysis patients enrolled between July 1, 2005 and December 31, 2014 and followed to June 30, 2015. Patient's demographic characteristics as well as clinical and laboratory measurements were collected.
  
  
  RESULTS
  Of 253 patients evaluated, 36 patients (14.2%) suffered from hypomagnesemia. During a median follow-up of 29 months (range: 4-120 months), 60 patients (23.7%) died, and 35 (58.3%) of these deaths were attributed to cardiovascular causes. Low serum magnesium was positively associated with peritoneal dialysis duration (r = 0.303, p < 0.001) as well as serum concentrations of albumin (r = 0.220, p < 0.001), triglycerides (r = 0.160, p = 0.011), potassium (r = 0.156, p = 0.013), calcium(r = 0.299, p < 0.001)and phosphate (r = 0.191, p = 0.002). Patients in the hypomagnesemia group had a lower survival rate than those in the normal magnesium groups (p < 0.001). In a multivariate Cox proportional hazards regression analysis, serum magnesium was an independent negative predictor of all-cause mortality (hazard ratio [HR] = 0.075, p = 0.011) and cardiovascular mortality (HR = 0.003, p < 0.001), especially in female patients. However, in univariate and multivariate Cox analysis, △Mg(difference between 1-year magnesium and baseline magnesium) was not an independent predictor of all-cause mortality and cardiovascular mortality.
  
  
  CONCLUSIONS
  Hypomagnesemia was common among peritoneal dialysis patients and was independently associated with all-cause mortality and cardiovascular mortality.
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Kedan
authors.initials: K
authors.lastname: Cai
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Dai
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Beixia
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Jinping
authors.initials: J
authors.lastname: Fei
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Congping
authors.initials: C
authors.lastname: Xue
authors.affiliation: Department of Nephrology, Ningbo No. 2 Hospital, Ningbo University School of Medicine, Zhejiang, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wu
mesh_terms: D002423:Cause of Death; D003710:Demography; D005260:Female; D006801:Humans; D053565:Hypercalciuria / Q000097:blood*; D008274:Magnesium / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009397:Nephrocalcinosis / Q000097:blood*; D010530:Peritoneal Dialysis / Q000401:mortality*; D015499:Renal Tubular Transport, Inborn Errors / Q000097:blood*; D016019:Survival Analysis
chemical_list: D008274:Magnesium