Magnesium to Prevent Kidney Disease-associated Vascular Calcification: Crystal Clear?

Overview

Journal Nephrol Dial Transplant

Publisher Oxford University Press

Specialties General Surgery
Nephrology

Date 2020 Dec 29

PMID 33374019

Citations 17

Authors

Anique D Ter Braake

Marc G Vervloet

Jeroen H F de Baaij

Joost G J Hoenderop

Affiliations

Soon will be listed here.

Abstract

Vascular calcification is a prognostic marker for cardiovascular mortality in chronic kidney disease (CKD) patients. In these patients, magnesium balance is disturbed, mainly due to limited ultrafiltration of this mineral, changes in dietary intake and the use of diuretics. Observational studies in dialysis patients report that a higher blood magnesium concentration is associated with reduced risk to develop vascular calcification. Magnesium prevents osteogenic vascular smooth muscle cell transdifferentiation in in vitro and in vivo models. In addition, recent studies show that magnesium prevents calciprotein particle maturation, which may be the mechanism underlying the anti-calcification properties of magnesium. Magnesium is an essential protective factor in the calcification milieu, which helps to restore the mineral-buffering system that is overwhelmed by phosphate in CKD patients. The recognition that magnesium is a modifier of calciprotein particle maturation and mineralization of the extracellular matrix renders it a promising novel clinical tool to treat vascular calcification in CKD. Consequently, the optimal serum magnesium concentration for patients with CKD may be higher than in the general population.

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References

de Roij van Zuijdewijn C, Grooteman M, Bots M, Blankestijn P, Steppan S, Buchel J . Serum Magnesium and Sudden Death in European Hemodialysis Patients. PLoS One. 2015; 10(11):e0143104. PMC: 4658157. DOI: 10.1371/journal.pone.0143104. View

Kircelli F, Peter M, Sevinc Ok E, Celenk F, Yilmaz M, Steppan S . Magnesium reduces calcification in bovine vascular smooth muscle cells in a dose-dependent manner. Nephrol Dial Transplant. 2011; 27(2):514-21. PMC: 3275783. DOI: 10.1093/ndt/gfr321. View

Montezano A, Zimmerman D, Yusuf H, Burger D, Chignalia A, Wadhera V . Vascular smooth muscle cell differentiation to an osteogenic phenotype involves TRPM7 modulation by magnesium. Hypertension. 2010; 56(3):453-62. DOI: 10.1161/HYPERTENSIONAHA.110.152058. View

Floege J . Magnesium Concentration in Dialysate: Is Higher Better?. Clin J Am Soc Nephrol. 2018; 13(9):1309-1310. PMC: 6140564. DOI: 10.2215/CJN.08380718. View

Fang X, Wang K, Han D, He X, Wei J, Zhao L . Dietary magnesium intake and the risk of cardiovascular disease, type 2 diabetes, and all-cause mortality: a dose-response meta-analysis of prospective cohort studies. BMC Med. 2016; 14(1):210. PMC: 5143460. DOI: 10.1186/s12916-016-0742-z. View

TenHuisen K, Brown P . Effects of magnesium on the formation of calcium-deficient hydroxyapatite from CaHPO4.2H2O and Ca4(PO4)2O. J Biomed Mater Res. 1997; 36(3):306-14. DOI: 10.1002/(sici)1097-4636(19970905)36:3<306::aid-jbm5>3.0.co;2-i. View

Salem S, Bruck H, Bahlmann F, Peter M, Passlick-Deetjen J, Kretschmer A . Relationship between magnesium and clinical biomarkers on inhibition of vascular calcification. Am J Nephrol. 2011; 35(1):31-9. DOI: 10.1159/000334742. View

Proudfoot D, Shanahan C, Weissberg P . Vascular calcification: new insights into an old problem. J Pathol. 1998; 185(1):1-3. DOI: 10.1002/(SICI)1096-9896(199805)185:1<1::AID-PATH89>3.0.CO;2-J. View

Ruospo M, Palmer S, Natale P, Craig J, Vecchio M, Elder G . Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD). Cochrane Database Syst Rev. 2018; 8:CD006023. PMC: 6513594. DOI: 10.1002/14651858.CD006023.pub3. View

10.

Shechter M . Magnesium and cardiovascular system. Magnes Res. 2010; 23(2):60-72. DOI: 10.1684/mrh.2010.0202. View

11.

Sakaguchi Y, Hamano T, Wada A, Hoshino J, Masakane I . Magnesium and Risk of Hip Fracture among Patients Undergoing Hemodialysis. J Am Soc Nephrol. 2017; 29(3):991-999. PMC: 5827604. DOI: 10.1681/ASN.2017080849. View

12.

He Y, Yao G, Savoia C, Touyz R . Transient receptor potential melastatin 7 ion channels regulate magnesium homeostasis in vascular smooth muscle cells: role of angiotensin II. Circ Res. 2004; 96(2):207-15. DOI: 10.1161/01.RES.0000152967.88472.3e. View

13.

Steitz S, Speer M, Curinga G, Yang H, Haynes P, Aebersold R . Smooth muscle cell phenotypic transition associated with calcification: upregulation of Cbfa1 and downregulation of smooth muscle lineage markers. Circ Res. 2001; 89(12):1147-54. DOI: 10.1161/hh2401.101070. View

14.

Wu M, Rementer C, Giachelli C . Vascular calcification: an update on mechanisms and challenges in treatment. Calcif Tissue Int. 2013; 93(4):365-73. PMC: 3714357. DOI: 10.1007/s00223-013-9712-z. View

15.

Cunningham J, Rodriguez M, Messa P . Magnesium in chronic kidney disease Stages 3 and 4 and in dialysis patients. Clin Kidney J. 2015; 5(Suppl 1):i39-i51. PMC: 4455820. DOI: 10.1093/ndtplus/sfr166. View

16.

Zhang K, Zhang Y, Feng W, Chen R, Chen J, Touyz R . Interleukin-18 Enhances Vascular Calcification and Osteogenic Differentiation of Vascular Smooth Muscle Cells Through TRPM7 Activation. Arterioscler Thromb Vasc Biol. 2017; 37(10):1933-1943. DOI: 10.1161/ATVBAHA.117.309161. View

17.

Sakaguchi Y, Shoji T, Hayashi T, Suzuki A, Shimizu M, Mitsumoto K . Hypomagnesemia in type 2 diabetic nephropathy: a novel predictor of end-stage renal disease. Diabetes Care. 2012; 35(7):1591-7. PMC: 3379604. DOI: 10.2337/dc12-0226. View

18.

LeGeros R, Contiguglia S, Alfrey A . Pathological calcifications associated with uremia: two types of calcium phosphate deposits. Calcif Tissue Res. 1973; 13(3):173-85. DOI: 10.1007/BF02015408. View

19.

Bressendorff I, Hansen D, Pasch A, Holt S, Schou M, Brandi L . The effect of increasing dialysate magnesium on calciprotein particles, inflammation and bone markers: post hoc analysis from a randomized controlled clinical trial. Nephrol Dial Transplant. 2019; 36(4):713-721. DOI: 10.1093/ndt/gfz234. View

20.

Kieboom B, Niemeijer M, Leening M, van den Berg M, Franco O, Deckers J . Serum Magnesium and the Risk of Death From Coronary Heart Disease and Sudden Cardiac Death. J Am Heart Assoc. 2016; 5(1). PMC: 4859391. DOI: 10.1161/JAHA.115.002707. View