The Relationship between Magnesium and Endothelial Function in End-Stage Renal Disease Patients on Hemodialysis.
OBJECTIVE
Chronic kidney disease (CKD) patients tend to have higher serum magnesium values than healthy population due to their positive balance of magnesium in kidney. Recent studies found that magnesium level is positively correlated with endothelial function. Therefore, this study was conducted to define the relationship between magnesium level and endothelial dysfunction in end stage renal disease (ESRD) patients on hemodialysis (HD).


METHODS
A total of 27 patients were included in this cross-sectional study. Iontophoresis with laser-Doppler flowmetry, flow mediated dilation (FMD), and carotid intima-media thickness were measured. Patients' average serum magnesium levels were measured over previous three months, including the examination month. Pearson's correlation coefficient analysis and multivariate regression model were used to define the association between magnesium and endothelial function.


RESULTS
In the univariate analysis, higher magnesium levels were associated with better endothelium-dependent vasodilation (EDV) of the FMD in ESRD patients on HD (r=0.516, p=0.007). When the participants were divided into two groups according to the median magnesium level (3.47 mg/dL), there was a significant difference in EDV of FMD (less than 3.47 mg/dL, 2.8±1.7%; more than 3.47 mg/dL, 5.1±2.0%, p=0.004). In multivariate analysis, magnesium and albumin were identified as independent factors for FMD (β=1.794, p=0.030 for serum magnesium; β=3.642, p=0.012 for albumin).


CONCLUSIONS
This study demonstrated that higher serum magnesium level may be associated with better endothelial function in ESRD patients on HD. In the future, a large, prospective study is needed to elucidate optimal range of serum magnesium levels in ESRD on HD patients.
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Shina
S
Lee
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Jung Hwa
JH
Ryu
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Seung Jung
SJ
Kim
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Dong Ryeol
DR
Ryu
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Duk Hee
DH
Kang
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. kbchoi@ewha.ac.kr.
Kyu Bok
KB
Choi
D000328:Adult; D000368:Aged; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000473:pathology / Q000502:physiology; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000097:blood*; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood; D014652:Vascular Diseases; D014664:Vasodilation
D008274:Magnesium
Magnesium; endothelium; hemodialysis; microcirculation