Is Low Magnesium a Clue to Arteriovenous Fistula Complications in Hemodialysis?

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2016 Jan 20

PMID 26781652

Citations 2

Authors

Radojica V Stolic

Aleksandar N Jovanovic

Goran Z Trajkovic

Mirjana M Kostic

Andrijana M Odalovic

Sasa R Sovtic

Maja V Sipic

Slavica D Pajovic

Zorica N Sojevic-Timotijevic

Affiliations

Soon will be listed here.

Abstract

Purpose: Magnesium insufficiency is a pro-atherogenic factor involved in endothelial dysfunction, atherosclerosis, and vascular calcification. Our aim was to examine the role of magnesium in the development of arteriovenous fistula complications in hemodialysis.

Methods: This was a retrospective clinical investigation of data from 88 patients who were divided into two groups: those with and without arteriovenous fistula complications. We examined the influence of sex, demographics, and clinical and laboratory parameters. The existence of fistula stenosis was determined by measuring Doppler flow, while B-mode ultrasound was used to detect plaques and evaluate the carotid artery intima-media thickness.

Results: Patients with arteriovenous fistula complications had significantly higher leukocyte counts (p = 0.03), platelet counts (p = 0.03), phosphate concentrations (p = 0.044), and alkaline phosphatase concentrations (p = 0.04). Patients without complications had significantly greater blood flow through the arteriovenous fistula (p < 0.0005), higher magnesium concentrations (p = 0.004), and a lower carotid artery intima-media thickness (p = 0.037). The magnesium level was inversely correlated with leukocyte (p = 0.028) and platelet (p = 0.016) counts. The magnesium concentration was significantly lower in patients with carotid artery plaques (p = 0.03). Multiple linear regression, using magnesium as the dependent variable in patients with arteriovenous fistula complications, indicated statistically significant correlations with platelet (p = 0.005) and leukocyte (p = 0.027) counts and carotid plaques (p = 0.045).

Conclusions: Hypomagnesemia is a significant pro-atherogenic factor and an important predictor of arteriovenous fistula complications.

Citing Articles

Hypomagnesemia as a Risk Factor and Accelerator for Vascular Aging in Diabetes Mellitus and Chronic Kidney Disease.

Petho A, Tapolyai M, Browne M, Fulop T Metabolites. 2023; 13(2).

PMID: 36837924 PMC: 9959098. DOI: 10.3390/metabo13020306.

Wu P, Lee S, Chang K, Chao C, Huang J Healthcare (Basel). 2021; 9(8).

PMID: 34442116 PMC: 8394860. DOI: 10.3390/healthcare9080979.

References

Kanbay M, Yilmaz M, Apetrii M, Saglam M, Yaman H, Unal H . Relationship between serum magnesium levels and cardiovascular events in chronic kidney disease patients. Am J Nephrol. 2012; 36(3):228-37. DOI: 10.1159/000341868. View

Floege J . Magnesium in CKD: more than a calcification inhibitor?. J Nephrol. 2014; 28(3):269-77. PMC: 4439441. DOI: 10.1007/s40620-014-0140-6. View

Nicoll R, Howard J, Henein M . A review of the effect of diet on cardiovascular calcification. Int J Mol Sci. 2015; 16(4):8861-83. PMC: 4425113. DOI: 10.3390/ijms16048861. View

Allon M, Robbin M . Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int. 2002; 62(4):1109-24. DOI: 10.1111/j.1523-1755.2002.kid551.x. View

Bonjour J, Gueguen L, Palacios C, Shearer M, Weaver C . Minerals and vitamins in bone health: the potential value of dietary enhancement. Br J Nutr. 2009; 101(11):1581-96. DOI: 10.1017/S0007114509311721. View

Stolic R, Trajkovic G, Kostic M, Stolic D, Miric D, Kisic B . Predictive value of serum myeloperoxidase activity for thrombosis of arteriovenous fistulas. Hemodial Int. 2014; 18(3):680-5. DOI: 10.1111/hdi.12155. View

Polkinghorne K, Lau K, Saunder A, Atkins R, Kerr P . Does monthly native arteriovenous fistula blood-flow surveillance detect significant stenosis--a randomized controlled trial. Nephrol Dial Transplant. 2006; 21(9):2498-506. DOI: 10.1093/ndt/gfl242. View

Geroulakos G, OGorman D, Kalodiki E, Sheridan D, Nicolaides A . The carotid intima-media thickness as a marker of the presence of severe symptomatic coronary artery disease. Eur Heart J. 1994; 15(6):781-5. DOI: 10.1093/oxfordjournals.eurheartj.a060585. View

Tzanakis I, Virvidakis K, Tsomi A, Mantakas E, Girousis N, Karefyllakis N . Intra- and extracellular magnesium levels and atheromatosis in haemodialysis patients. Magnes Res. 2004; 17(2):102-8. View

10.

Ortega O, Rodriguez I, Cobo G, Hinostroza J, Gallar P, Mon C . Lack of influence of serum magnesium levels on overall mortality and cardiovascular outcomes in patients with advanced chronic kidney disease. ISRN Nephrol. 2014; 2013:191786. PMC: 4045427. DOI: 10.5402/2013/191786. View

11.

Papagianni A, Kalovoulos M, Kirmizis D, Vainas A, Belechri A, Alexopoulos E . Carotid atherosclerosis is associated with inflammation and endothelial cell adhesion molecules in chronic haemodialysis patients. Nephrol Dial Transplant. 2002; 18(1):113-9. DOI: 10.1093/ndt/18.1.113. View

12.

MEEMA H, Oreopoulos D, Rapoport A . Serum magnesium level and arterial calcification in end-stage renal disease. Kidney Int. 1987; 32(3):388-94. DOI: 10.1038/ki.1987.222. View

13.

Floridis J, Abeyaratne A, Majoni S . Prevalence and clinical impact of magnesium disorders in end-stage renal disease: a protocol for a systematic review. Syst Rev. 2015; 4:76. PMC: 4446798. DOI: 10.1186/s13643-015-0063-x. View

14.

Sakaguchi Y, Fujii N, Shoji T, Hayashi T, Rakugi H, Isaka Y . Hypomagnesemia is a significant predictor of cardiovascular and non-cardiovascular mortality in patients undergoing hemodialysis. Kidney Int. 2013; 85(1):174-81. DOI: 10.1038/ki.2013.327. View

15.

Ishimura E, Okuno S, Kitatani K, Tsuchida T, Yamakawa T, Shioi A . Significant association between the presence of peripheral vascular calcification and lower serum magnesium in hemodialysis patients. Clin Nephrol. 2007; 68(4):222-7. DOI: 10.5414/cnp68222. View

16.

Kanbay M, Goldsmith D, Erkmen Uyar M, Turgut F, Covic A . Magnesium in chronic kidney disease: challenges and opportunities. Blood Purif. 2010; 29(3):280-92. DOI: 10.1159/000276665. View

17.

Maier J . Endothelial cells and magnesium: implications in atherosclerosis. Clin Sci (Lond). 2012; 122(9):397-407. DOI: 10.1042/CS20110506. View

18.

Mortazavi M, Moeinzadeh F, Saadatnia M, Shahidi S, McGee J, Minagar A . Effect of magnesium supplementation on carotid intima-media thickness and flow-mediated dilatation among hemodialysis patients: a double-blind, randomized, placebo-controlled trial. Eur Neurol. 2013; 69(5):309-16. DOI: 10.1159/000346427. View

19.

Courivaud C, Davenport A . Magnesium and the risk of all-cause and cardiac mortality in hemodialysis patients: agent provocateur or innocent bystander?. Kidney Int. 2014; 85(1):17-20. DOI: 10.1038/ki.2013.301. View

20.

Geiger H, Wanner C . Magnesium in disease. Clin Kidney J. 2015; 5(Suppl 1):i25-i38. PMC: 4455821. DOI: 10.1093/ndtplus/sfr165. View