Magnesium in Chronic Kidney Disease: Should We Care?

• Published in: Blood purification Vol. 45; no. 1-3; pp. 173 - 178
• Main Authors: van de Wal-Visscher, Esther R., Kooman, Jeroen P., van der Sande, Frank M.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2018
• Subjects: Cardiac Conduction System Disease - blood; Cardiac Conduction System Disease - etiology; Cardiac Conduction System Disease - physiopathology; Glomerular Filtration Rate; Humans; Hypertension - blood; Hypertension - etiology; Hypertension - physiopathology; Kidney - metabolism; Kidney - pathology; Kidney - physiopathology; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - physiopathology; Magnesium - blood; Muscle Weakness - blood; Muscle Weakness - etiology; Muscle Weakness - physiopathology; Renal Dialysis - adverse effects; Review – Advances in CKD 2018; Vascular Calcification - blood; Vascular Calcification - etiology; Vascular Calcification - physiopathology; Chronic kidney disease; Magnesium; Haemodialysis; (Patho) physiology; Outcome
• ISSN: 0253-5068; 1421-9735
• DOI: 10.1159/000485212

Background: Magnesium (Mg) is an essential cation for multiple processes in the body. The kidney plays a major role in regulating the Mg balance. In a healthy individual, total-body Mg content is kept constant by interactions among intestine, bones and the kidneys. Summary: In case of chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal Mg absorption. Usually Mg remains normal; however, when glomerular filtration rate declines, changes in serum Mg are observed. Patients with end-stage renal disease on dialysis are largely dependent on the dialysate Mg concentration for maintaining serum Mg and Mg homeostasis. A low Mg is associated with several complications such as hypertension, and vascular calcification, and also associated with an increased risk for both cardiovascular disease (CVD) and non-CVD mortality. Severe hypermagnesaemia is known to cause cardiac conduction defects, neuromuscular effects and muscle weakness; a slightly elevated Mg has been suggested to be beneficial in patients with end-stage renal disease. Key Messages: The role of both low and high Mg, in general, but especially in relation to CKD and dialysis patients is discussed.