Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients

Abstract

Introduction: The homeostasis of magnesium (Mg) is perturbed in chronic kidney disease. It has been supposed that plasma Mg has a principal role to regulate the secretion of parathyroid hormone (PTH). Plasma Mg is capable of modulating secretion of PTH. Recent investigations showed that low serum Mg levels in patients with kidney disease have been linked to increased mortality. Objectives: The aim of this study was to determine the relationship between serum Mg and PTH levels in hemodialysis patients. Patients and Methods:This cross-sectional study was conducted on 56 hemodialysis patients in hemodialysis center of Hajar hospital of Shahrekord in 2015. Regular hemodialysis patients who had at least three months history of dialysis were enrolled to the study. The serum levels of Mg, calcium, phosphorus, intact PTH (iPTH), alkaline phosphatase, albumin and bicarbonate were measured. Results: In this study, 61.5% of the 52 patients were male. Mean ± standard deviation (SD) of patients' age was 60.5 ± 17.7 years with median of 63 years old. The average duration of dialysis was 44±39.5 months (median 36 months). Additionally the dialysis dose was 517 ± 479 weeks (median; 414 weeks). Mean ± SD of serum iPTH and Mg were 360.1 ± 238.2 pg/mL and 2.2 ± 0.2 mg/mL respectively. In this study we found a significantly positive correlation of iPTH with serum Mg levels (r = 0.28, P = 0.04). Conclusion: This study shows impact of Mg on parathormone secretion. Our findings require further investigations with larger and multicentric studies. Please cite this paper as: Fooladgar M, Malekpour A, Asgari-Savadjani S, Mardani S. Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients. J Parathyr Dis. 2018;6(1):13-15.

Magnesium and parathyroid hormone among end-stage renal disease patients

“…In addition, the results of these studies are also conflicting (8,9). The results of the study by Fooladgar et al showed a positive relationship between iPTH and serum Mg levels among HD patients, however most of other studies in HD patients and also most of studies among ESRD patients undergoing peritoneal dialysis showed a significant inverse relationship between serum Mg and serum intact PTH levels (1,8,9). Therefore, as Fooladgar et al recommended, there still remains a number of big questions about this issue and it is necessary to further evaluate of role of Mg in secondary hyperparathyroidism and vascular calcification.…”

“…With great interest, we read the recently published article entitled "serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients" by Fooladgar and colleagues in Journal Parathyroid Disease (1). They evaluated, in a cross-sectional study, the serum levels of magnesium (Mg), calcium, phosphorus and intact PTH (iPTH) among 56 end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (HD) in a HD center (1).…”

“…They evaluated, in a cross-sectional study, the serum levels of magnesium (Mg), calcium, phosphorus and intact PTH (iPTH) among 56 end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (HD) in a HD center (1). The results of the study showed a significantly positive correlation between iPTH and serum Mg levels among these patients (1).…”

“…They evaluated, in a cross-sectional study, the serum levels of magnesium (Mg), calcium, phosphorus and intact PTH (iPTH) among 56 end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis (HD) in a HD center (1). The results of the study showed a significantly positive correlation between iPTH and serum Mg levels among these patients (1). Hypermagnesemia is an uncommon laboratory finding among healthy adults and symptomatic hypermagnesemia is a rare disorder among patients with normal renal function, because the normal kidney is able to rapidly excrete magnesium loading by reducing magnesium tubular reabsorption (2,3).…”

“…Hypermagnesemia is also not a prominent feature among patients with chronic kidney disease (CKD), in the absence of increased magnesium administration, however renal failure mostly at its final stages is most common cause of hypermagnesemia (4). The relationship between iPTH and serum Mg levels in healthy adults and CKD patients, the effect of hypermagnesemia on disorders of mineral and bone metabolism, and the effect of chronic hypermagnesemia on PTH levels among ESRD patients as evaluated by Fooladgar et al are important issues (1,(4)(5)(6)(7). It is suggested that, hypermagnesemia can inhibit the secretion of PTH among patients with normal renal function and it usually causes transient and asymptomatic hypocalcemia by this mechanism (2,3).…”