title: Magnesium and infection risk after kidney transplantation: An observational cohort study.
abstract: Magnesium is a co-factor in natural killer and T cell reactivity and may modify the course of infections. We examined the association between baseline serum magnesium concentration and infections requiring admission the first year after kidney transplantation.
  
  
  
  Inclusion of adults transplant recipients between January 2003 and 31 December 2013. Cox piecewise linear regression model estimating the hazard ratio for first admission for infection. Outcomes until one year post-transplantation or up to May 1, 2014.
  
  
  
  Overall, 371 of 873 persons were admitted at least once the first year after transplantation (65 events per 100 person-years). The infection-specific cumulative incidence increased with lower serum magnesium concentration (P = 0.008). After adjustment for confounders, a low serum magnesium was associated with an increased hazard of infection (P < 0.0001 in type 3 test). With 2 mg/dL as the reference value, every 0.1 mg/dL reduction in serum magnesium at baseline below 2 mg/dL (N = 165) increased the hazard ratio by 15% (HR 1.15, 95%CI 1.05-1.27; P = 0.002) while every increase of 0.1 mg/dL in those with a serum magnesium between 2 and 3 mg/dL (N = 661) decreased the hazard ratio by 4% (HR 0.96, 95%CI 0.93-1.00; P = 0.08).
  
  
  
  A lower baseline serum magnesium concentration is associated with an increased risk of infection after kidney transplantation.
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium. Electronic address: steven.vanlaecke@ugent.be.
authors.forename: Steven
authors.initials: S
authors.lastname: Van Laecke
authors.affiliation: Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge, Brugge, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Vermeiren
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.
authors.forename: Evi V
authors.initials: EV
authors.lastname: Nagler
authors.affiliation: Division of Nephrology, OLV Hospital, Aalst, Belgium.
authors.forename: Rogier
authors.initials: R
authors.lastname: Caluwe
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: De Wilde
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Van der Vennet
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Peeters
authors.affiliation: Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Caren
authors.initials: C
authors.lastname: Randon
authors.affiliation: Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Vermassen
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanholder
authors.affiliation: Renal Division, Department of Internal Medicine, Ghent University Hospital, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Van Biesen
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003141:Communicable Diseases / Q000453:epidemiology*; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D018570:Risk Assessment
chemical_list: D008274:Magnesium
keywords: Hospital admission; Lymphocyte; Magnesium; Transplantation