Nicoline H J Leenders1, Emma A Vermeulen2, Adriana J van Ballegooijen3, Tiny Hoekstra2, Ralph de Vries4, Joline W Beulens5, Marc G Vervloet2. 1. Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. Electronic address: n.leenders@amsterdamumc.nl. 2. Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 3. Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 4. Medical Library, Vrije Universiteit Amsterdam, the Netherlands. 5. Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Abstract
BACKGROUND & AIMS: Despite modern treatment, risk for cardiovascular disease and mortality in patients with chronic kidney disease (CKD) is unacceptably high. Observational studies have shown associations of magnesium with risk for several clinical outcomes in CKD of variable magnitude. The aim of this review is to provide a systematic overview and meta-analysis of longitudinal studies assessing the association of plasma magnesium concentration with clinically relevant outcomes in adult patients with chronic kidney disease, with a minimal follow-up of 6 months. Primary outcomes of interest were all-cause mortality, cardiovascular mortality, cardiovascular events, sudden death and hospitalisation. METHODS: The electronic databases PubMed, Embase and The Cochrane Library were searched using terms relating to plasma magnesium and CKD patients, and two authors independently selected eligible studies. Study quality was assessed according to the Newcastle-Ottawa Scale. Results of studies with a comparable magnesium exposure and outcome measure, were pooled using a random-effects meta-regression analysis. RESULTS: The search yielded 6156 records of which 33 studies, involving 348,059 patients, met the eligibility criteria. Finally, 22 studies could be included in the meta-analysis. Higher magnesium was associated with a lower risk for all-cause mortality (HR 0.90 [0.87-0.94] per 0.1 mmol/L increase of magnesium) and cardiovascular mortality and events (HR 0.85 [0.77-0.94] per 0.1 mmol/L). CONCLUSIONS: Magnesium concentration is inversely associated with all-cause mortality and cardiovascular mortality and events. Therefore, increasing magnesium may improve risk in patients with chronic kidney disease. This meta-analysis forms a firm base for future prospective trials to test whether increasing plasma magnesium, indeed has beneficial effects on clinical outcomes.
BACKGROUND & AIMS: Despite modern treatment, risk for cardiovascular disease and mortality in patients with chronic kidney disease (CKD) is unacceptably high. Observational studies have shown associations of magnesium with risk for several clinical outcomes in CKD of variable magnitude. The aim of this review is to provide a systematic overview and meta-analysis of longitudinal studies assessing the association of plasma magnesium concentration with clinically relevant outcomes in adult patients with chronic kidney disease, with a minimal follow-up of 6 months. Primary outcomes of interest were all-cause mortality, cardiovascular mortality, cardiovascular events, sudden death and hospitalisation. METHODS: The electronic databases PubMed, Embase and The Cochrane Library were searched using terms relating to plasma magnesium and CKD patients, and two authors independently selected eligible studies. Study quality was assessed according to the Newcastle-Ottawa Scale. Results of studies with a comparable magnesium exposure and outcome measure, were pooled using a random-effects meta-regression analysis. RESULTS: The search yielded 6156 records of which 33 studies, involving 348,059 patients, met the eligibility criteria. Finally, 22 studies could be included in the meta-analysis. Higher magnesium was associated with a lower risk for all-cause mortality (HR 0.90 [0.87-0.94] per 0.1 mmol/L increase of magnesium) and cardiovascular mortality and events (HR 0.85 [0.77-0.94] per 0.1 mmol/L). CONCLUSIONS:Magnesium concentration is inversely associated with all-cause mortality and cardiovascular mortality and events. Therefore, increasing magnesium may improve risk in patients with chronic kidney disease. This meta-analysis forms a firm base for future prospective trials to test whether increasing plasma magnesium, indeed has beneficial effects on clinical outcomes.
Authors: Nicoline H J Leenders; Caro Bos; Tiny Hoekstra; Leon J Schurgers; Marc G Vervloet; Joost G J Hoenderop Journal: Nephrol Dial Transplant Date: 2022-05-25 Impact factor: 7.186
Authors: Emma A Vermeulen; Coby Eelderink; Tiny Hoekstra; Adriana J van Ballegooijen; Pieter Raijmakers; Joline W Beulens; Martin H de Borst; Marc G Vervloet Journal: Trials Date: 2022-09-12 Impact factor: 2.728
Authors: Simone J M Stoots; Guido M Kamphuis; Rob Geraghty; Liffert Vogt; Michaël M E L Henderickx; B M Zeeshan Hameed; Sufyan Ibrahim; Amelia Pietropaolo; Enakshee Jamnadass; Sahar M Aljumaiah; Saeed B Hamri; Eugenio Ventimiglia; Olivier Traxer; Vineet Gauhar; Etienne X Keller; Vincent De Coninck; Otas Durutovic; Nariman K Gadzhiev; Laurian B Dragos; Tarik Emre Sener; Nick Rukin; Michele Talso; Panagiotis Kallidonis; Esteban Emiliani; Ewa Bres-Niewada; Kymora B Scotland; Naeem Bhojani; Athanasios Vagionis; Angela Piccirilli; Bhaskar K Somani Journal: J Clin Med Date: 2021-06-27 Impact factor: 4.241