Effects of Magnesium on the Phosphate Toxicity in Chronic Kidney Disease: Time for Intervention Studies.
Magnesium, an essential mineral for human health, plays a pivotal role in the cardiovascular system. Epidemiological studies in the general population have found an association between lower dietary magnesium intake and an elevated risk of cardiovascular events. In addition, magnesium supplementation was shown to improve blood pressure control, insulin sensitivity, and endothelial function. The relationship between magnesium and cardiovascular prognosis among patients with chronic kidney disease (CKD) has been increasingly investigated as it is becoming evident that magnesium can inhibit vascular calcification, a prominent risk of cardiovascular events, which commonly occurs in CKD patients. Cohort studies in patients receiving dialysis have shown a lower serum magnesium level as a significant risk for cardiovascular mortality. Interestingly, the cardiovascular mortality risk associated with hyperphosphatemia is alleviated among those with high serum magnesium levels, consistent with in vitro evidence that magnesium inhibits high-phosphate induced calcification of vascular smooth muscle cells. Furthermore, a harmful effect of high phosphate on the progression of CKD is also attenuated among those with high serum magnesium levels. The potential usefulness of magnesium as a remedy for phosphate toxicity should be further explored by future intervention studies.
Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita 565-0871, Japan. sakaguchi@kid.med.osaka-u.ac.jp.
Yusuke
Y
Sakaguchi
Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita 565-0871, Japan. hamatea@kid.med.osaka-u.ac.jp.
Takayuki
T
Hamano
Department of Nephrology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita 565-0871, Japan. isaka@kid.med.osaka-u.ac.jp.
Yoshitaka
Y
Isaka
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control; D015331:Cohort Studies; D004195:Disease Models, Animal; D018450:Disease Progression; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000188:drug therapy; D007333:Insulin Resistance; D008274:Magnesium / Q000008:administration & dosage*; D010710:Phosphates / Q000633:toxicity*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000209:etiology; D012307:Risk Factors; D061205:Vascular Calcification / Q000097:blood / Q000517:prevention & control
D010710:Phosphates; D008274:Magnesium
cardiovascular disease; chronic kidney disease; dialysis; magnesium; phosphate toxicity; vascular calcification