Beneficial effects of magnesium in chronic renal failure: a foe no longer.

Magnesium plays a critical role in cellular physiology in humans, regulating many fundamental functions. In the general population its deficiency is associated with many disorders, the most significant being cardiovascular diseases. The role of magnesium in many aspects of end-stage renal disease (ESRD) may be also very important, although this has not been explored in depth. The most significant of these roles are use of magnesium salts as phosphate binders and its ability to inhibit the development or progression of vascular calcification. Moreover, serum magnesium suppresses parathyroid hormone excretion, whereas high magnesium dialysate may result in intradialytic hemodynamic stability. Data provided by recent studies on these issues have promoted promising renewed interest in the role of magnesium in ESRD and its possible favorable therapeutic application in these patients. Further large studies are needed to establish its efficacy and safety, and, probably, to re-evaluate its appropriate concentration in hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) fluids.