Magnesium Replacement to Protect Cardiovascular and Kidney Damage? Lack of Prospective Clinical Trials

Muñoz‐Castañeda, Juan R.; Mier, M. Victoria Pendón-Ruiz de; Rodríguez, Mariano; Rodríguez‐Ortiz, María E.

doi:10.3390/ijms19030664

Cited by 32 publications

(19 citation statements)

References 122 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Owing to the positive impact of citrate containing fluids on the hemodynamic parameters and redox status of HD patients, it has recently been proposed to use citrate, instead of the less physiologic acetate, in DFs to improve the outcome of HD process in clinical practice [16,35]. Moreover, Mg deficiency is involved in the development and maintenance of an elevated oxidative stress status, contributing to CVD in HD patients [11,24,36]. Therefore, the use of DFs with high Mg concentrations could prevent uremia-induced oxidative stress in HD patients [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Low Mg levels are associated with CVD and high mortality in dialysis patients [3,21,24,46]. Serum Mg in HD patients is affected by the dialysate Mg concentration, which is low (0.5 mM) as standard [23,28,46], and may induce a post-dialytic hypomagnesemia and undesirable hemodynamic effects, such as hypotension, arrhythmia, and calcification) [23,30,46,47].…”

Section: Discussionmentioning

confidence: 99%

“…and reduces complement and leukocytes activation, improving dialysis efficiency [19,20].Magnesium (Mg) is very important for many basic physiological functions in the human body [21]. Epidemiological studies have demonstrated an association between hypomagnesemia (low serum Mg concentration) and CVD-associated mortality in CKD patients [21][22][23][24]. Moreover, exacerbated oxidative-inflammatory stress has been associated with hypomagnesemia in HD patients [12,24].…”

mentioning

confidence: 99%

“…Epidemiological studies have demonstrated an association between hypomagnesemia (low serum Mg concentration) and CVD-associated mortality in CKD patients [21][22][23][24]. Moreover, exacerbated oxidative-inflammatory stress has been associated with hypomagnesemia in HD patients [12,24]. Thus, it has been proposed that increasing the Mg concentration in DFs may be a useful strategy to prevent CVD associated oxidative stress in HD patients [12,21,22,[24][25][26][27][28].…”

mentioning

confidence: 99%

“…Moreover, exacerbated oxidative-inflammatory stress has been associated with hypomagnesemia in HD patients [12,24]. Thus, it has been proposed that increasing the Mg concentration in DFs may be a useful strategy to prevent CVD associated oxidative stress in HD patients [12,21,22,[24][25][26][27][28]. Mg concentration in DFs is one of the significant determinants of Mg serum balance in HD patients [25].…”

mentioning

confidence: 99%

See 4 more Smart Citations

Increasing the Magnesium Concentration in Various Dialysate Solutions Differentially Modulates Oxidative Stress in a Human Monocyte Cell Line

et al. 2020

View full text Add to dashboard Cite

es (M.A.) † These authors share senior authorship.Abstract: Oxidative stress is exacerbated in hemodialysis patients by several factors, including the uremic environment and the use of dialysis fluids (DFs). Since magnesium (Mg) plays a key role in modulating immune function and in reducing oxidative stress, we aimed to evaluate whether increasing the Mg concentration in different DFs could protect against oxidative stress in immunocompetent cells in vitro. Effect of ADF (acetate 3 mM), CDF (citrate 1 mM), and ACDF (citrate 0.8 mM + acetate 0.3 mM) dialysates with Mg at standard (0.5 mM) or higher (1, 1.25, and 2 mM) concentrations were assessed in THP-1 monocyte cultures. Reactive oxygen species (ROS) and malondialdehyde (MDA) levels were quantified under basal and uremic conditions (indoxyl sulfate (IS) treatment). Under uremic conditions, the three DFs with 0.5 mM Mg promoted higher ROS production and lipid damage than the control solution. However, CDF and ACDF induced lower levels of ROS and MDA, compared to that induced by ADF. High Mg concentration (1.25 and/or 2 mM) in CDF and ACDF protected against oxidative stress, indicated by reduced ROS and MDA levels compared to respective DFs with standard concentration of Mg. Increasing Mg concentrations in ADF promoted high ROS production and MDA content. Thus, an increase in Mg content in DFs has differential effects on the oxidative stress in IS-treated THP-1 cells depending on the dialysate used. renal function and the prevalence of cardiovascular events through altered leukocyte activation and intensified oxidative stress [3][4][5][6][7].Classically, UTs are divided into three categories: low-molecular-weight water-soluble solutes (<500 Da), middle-molecular-weight solutes (>500 Da), and protein-bound solutes [8]. These uremic toxins, represented by IS, is extremely toxic and difficult to eliminate by conventional dialysis; consequently, high IS levels may trigger oxidative-inflammatory stress, playing a key pathophysiologic role in CKD. In fact, several studies have confirmed that the occurrence of CVD induced by CKD is closely related to the IS accumulation [3].Uremia promotes a state of enhanced oxidative stress, which is the result of pro-oxidant molecules, such as reactive oxygen species (ROS), overwhelming the antioxidant defense mechanisms [9]. An increase in oxidative stress occurs during the dialysis session owing to the loss of antioxidants (e.g., uric acid, etc.) and the activation of leukocytes, which trigger both inflammatory compounds and ROS production, contributing to oxidative damage of biomolecules (e.g., lipid peroxidation, DNA damage, etc.) [3,[9][10][11][12].Clinical and experimental evidence demonstrates that several factors inherent to the dialysis procedure itself, such as dialysis modality, iron administration, biocompatibility, and types of dialyzer membrane and dialysates, can play a key role promoting chronic inflammation and oxidative stress in HD patients [9][10][11][12]. Bio-incompatibility during HD induces leukocyte activation...

show abstract