Hypomagnesemia as a risk factor for the non-recovery of the renal function in critically ill patients with acute kidney injury

Alves, Sarah Cascaes; Tomasi, Cristiane Damiani; Constantino, Larissa; Giombelli, Vinícius Renê; Candal, R.; Bristot, Maria de Lourdes Ugioni; Topanotti, Maria Fernanda Locks; Burdmann, Emmanuel A.; Dal‐Pizzol, Felipe; Fraga, Cassiana Mazon; Ritter, Cristiane

doi:10.1093/ndt/gfs268

Cited by 60 publications

(41 citation statements)

References 19 publications

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“…On the basis of the reduction in mouse maternal plasma Mg concentrations with respect to previously published guidelines (22,23), this model appears to produce moderate Mg deficiency. Maternal plasma Mg concentrations decline over the course of pregnancy (24).…”

Section: Discussionmentioning

confidence: 73%

Maternal Magnesium Deficiency in Mice Leads to Maternal Metabolic Dysfunction and Altered Lipid Metabolism with Fetal Growth Restriction

Gupta

Solanki

Chatterjee

et al. 2014

Mol Med

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Section: Discussionmentioning

confidence: 73%

Maternal Magnesium Deficiency in Mice Leads to Maternal Metabolic Dysfunction and Altered Lipid Metabolism with Fetal Growth Restriction

Gupta

Solanki

Chatterjee

et al. 2014

Mol Med

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“…Hypomagnesaemia deserves a special consideration because recent studies reported this disturbance as an independent risk factor for the development of AKI and non-recovery of RF in critically ill patients with AKI [43] . In animal experiments, hypomagnesaemia decreases the GFR and RBF, and enhances post-ischemic renal injury [44] .…”

Section: It Is Not All About Rrt Volume Statusmentioning

confidence: 99%

Delayed Nephrology Consultation and High Mortality on Acute Kidney Injury: A Meta-Analysis

Soares¹,

Pessanha

Sharma³

et al. 2016

Blood Purif

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Background: Acute kidney injury (AKI) is a complex syndrome associated with substantial morbidity, mortality and costs. Despite advancements in diagnosis and care practice, AKI remains a disorder usually under/late-recognized with high mortality. One of the hidden reasons for poor outcome might be delayed nephrology consultation, with the involvement of the specialist only in severe stages of AKI when renal replacement therapy (RRT) is required. Methods: We searched PubMed, EMBASE and Cochrane central register for related work on the subject. Six studies were identified for the meta-analysis, correlating time of nephrology consultation and mortality in AKI. Results: We found that delayed nephrology consultation is associated with higher mortality in AKI, with an OR 0.79 (95% CI 0.48-1.10, p < 0.05). Conclusion: Delayed nephrology consultation contributes to higher mortality in AKI. The early involvement of nephrologist may present an advantage in terms of early recognition, prevention and effective treatment of AKI. An early involvement of multidisciplinary task force may contribute to better treatment, before the preventable complications of AKI occur or an emergency RRT is required.

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“…Interestingly, experimental data have reported a reduction in glomerular filtration rate (GFR) and of renal blood flow (RBF) in relation with a concentration of magnesium lower than normal values, and a restoration of GFR and RBF after magnesium administration [17]. Recently, both hypomagnesemia and ionized hypomagnesemia have been reported as being associated with a worse prognosis, especially for a non-recovery renal function after development of acute kidney injury (AKI) [18], as well as longer ICU stay and greater mortality [19]. Therefore, when dealing with fluid replacement and the necessity of intravenous fluid replacement, it may be reasonable to employ intravenous fluids also including magnesium, in order to prevent hypomagnesemia.…”

Section: Magnesiummentioning

confidence: 99%

Intravenous balanced solutions: from physiology to clinical evidence

Länger

Santini

Scotti

et al. 2015

Anaesthesiol Intensive Ther

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Abstract"Balanced" solutions are commonly defined as intravenous fluids having an electrolyte composition close to that of plasma. As such, they should minimally affect acid-base equilibrium, as compared to the commonly reported 0.9% NaCl-related hyperchloremic metabolic acidosis. Recently, the term "balanced" solution has been also employed to indicate intravenous fluids with low chloride content, being the concentration of this electrolyte the most altered in 0.9% NaCl as compared to plasma, and based upon a suggested detrimental alteration of renal function associated with hyperchloremia. Despite efforts made towards its identification, the ideal balanced solution, with minimal effects on acid-base status, low chloride content, and adequate tonicity, is not yet available. After the accumulation of pre-clinical and clinical physiologic data, in the last three years, several clinical trials, mostly observational and retrospective, have addressed the question of whether the use of balanced solutions has beneficial effects as compared to the standard of care, sometimes even suggesting an improvement in survival. Nonetheless, the first large randomized controlled trial comparing the effects of a balanced vs. unbalanced solutions on renal function in critically-ill patients (SPLIT trial, the 0.9% saline vs. Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy), just recently published, showed identical equipoise between the two treatments. In the present review, we offer a comprehensive and updated summary on this issue, firstly, by providing a full physiological background of balanced solutions; secondly, by summarizing their potential pathophysiologic effects; and lastly, by presenting the clinical evidence available to support their use at the present time.

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Hypomagnesemia as a risk factor for the non-recovery of the renal function in critically ill patients with acute kidney injury

Abstract: Hypomagnesemia was an independent risk factor for non-recovery of renal function in a cohort of critically ill AKI patients.

Cited by 60 publications

References 19 publications

Maternal Magnesium Deficiency in Mice Leads to Maternal Metabolic Dysfunction and Altered Lipid Metabolism with Fetal Growth Restriction

Maternal Magnesium Deficiency in Mice Leads to Maternal Metabolic Dysfunction and Altered Lipid Metabolism with Fetal Growth Restriction

Delayed Nephrology Consultation and High Mortality on Acute Kidney Injury: A Meta-Analysis

Intravenous balanced solutions: from physiology to clinical evidence

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