Evaluation of Peripheral Vascular Calcification and Serum Magnesium Level in a Group of Egyptian Hemodialysis Patients

Abstract

Introduction: Vascular calcification is a risk factor for cardiovascular mortality in the general population. It is highly prevalent in end stage renal disease (ESRD) patients. Low magnesium (Mg) levels have been reported to have a strong association with vascular calcification in hemodialysis (HD) patients. The aims of this study were to evaluate the prevalence of vascular calcification and its relation to serum Mg concentration in a group of Egyptian HD patients. Methods:We studied 65 stable patients undergoing maintenance HD for more than 6 months. Vascular calcification was evaluated using hand roentgenography. Serum Mg, phosphorus, corrected calcium and intact parathyroid hormone (iPTH) levels were compared between patients with and without vascular calcification. Results:The study included 41 male and 24 female patients, aged 43-70 years. Vascular calcification was present in 38.5% of the patients. Mean serum Mg level was 2.88 ± 0.51 mg/dl. Male gender was more common in patients with vascular calcification, and they had significantly longer HD duration and significantly higher serum phosphorus and iPTH levels. Serum Mg level was significantly lower in patients with vascular calcification (2.36 ± 0.26 mg/dl vs.3.21 ± 0.32 mg/dl, p = 0.001). Serum Mg concentration remained as independent negative predictor of hand-artery vascular calcification after adjustment for age, gender, duration of HD, serum phosphorus and iPTH levels. Conclusion:Vascular calcification is common in the study population and is associated with a lower serum Mg level. High or sustained-normal Mg levels may have a protective role against the development of vascular calcification in HD patients.

Magnesium and Mortality in Patients with Diabetes and Early Chronic Kidney Disease

“…These data seem to be in accordance with previously reported in vitro and clinical studies that have already correlated lower Mg levels with vascular calcification [13,23,24], and cardiovascular mortality [25] in hemodialysis patients and also with progression to ESRD [22] as well as data from animal [26] and in vitro [27][28][29] studies stating that increased Mg levels protect against vascular calcification.…”

Serum fetuin-A as a perdictive biomarker of chronic kidney disease

“…Clinical and epidemiological studies have consistently suggested that vascular calcifications and hence arterial stiffness play an important role in the pathogenesis of cardiovascular disease and are a strong risk factor for increased morbidity and mortality in patients with end-stage renal disease (ESRD) [13]. [14] reported that vascular calcification is common in the study population and is associated with a lower serum fetuin-A level. High or sustained-normal serum fetuin-A levels may have a protective role against the development of vascular calcification in HD patients.…”

Magnesium and Kidney Disease

“…Earlier, Izawa et al [ 116 ] had described a haemodialysis patient in whom soft-tissue calci fi cation resolved after treatment with a dialysate with a high concentration of magnesium. Subsequently, other clinical studies demonstrated a clear association between low magnesium and arterial calci fi cations or other atherosclerotic lesions in dialysed renal patients [115][116][117][118][119][120][121][122][123][124] . In a number of clinical studies, a correlation of low serum magnesium with either vascular calci fi cations or carotid intima-media thickness (an index of atherosclerosis) has been demonstrated in ESRD patients.…”