Cardiovascular and All-Cause Mortality Is Affected by Serum Magnesium and Diet Pattern in a Cohort of Dialysis Patients

被引：1

作者：

Petrakis, Ioannis ^{[1
]}

Bacharaki, Dimitra ^{[2
]}

Kyriazis, Periklis ^{[3
]}

Balafa, Olga ^{[4
]}

Dounousi, Evangelia ^{[4
]}

Tsirpanlis, George ^{[5
]}

Theodoridis, Marios ^{[6
]}

Tsotsorou, Ourania ^{[2
]}

Markaki, Anastasia ^{[7
]}

Georgoulidou, Anastasia ^{[8
]}

Triantafyllis, George ^{[9
]}

Giannikouris, Ioannis ^{[9
]}

Kokkalis, Apostolos ^{[10
]}

Stavroulopoulos, Aristeides ^{[11
,12
]}

Stylianou, Kostas ^{[1
]}

机构：

[1] Univ Gen Hosp Heraklion, Nephrol Dept, Iraklion 71500, Greece

[2] Attikon Univ Hosp, Nephrol Dept, Athens 12462, Greece

[3] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Nephrol, Boston, MA 02215 USA

[4] Univ Hosp Ioannina, Nephrol Dept, Ioannina 45500, Greece

[5] Gen Hosp Athens G Gennimatas, Nephrol Dept, Athens 11527, Greece

[6] Democritus Univ Thrace, Dept Nephrol, Alexendroupolis 68150, Greece

[7] Hellen Mediterranean Univ, Dept Nutr & Dietet, Iraklion 71410, Greece

[8] Gen Hosp Komotini, Nephrol Dept, Komotini 69133, Greece

[9] Mediterraneo Hosp, Dept Nephrol, Hemodial Unit, Glifadha 16675, Greece

[10] Ionio Salaminas Hemodial Ctr, Salamina 18900, Greece

[11] IASIO Hosp, Nephrol Dept, Gen Clin Kalithea, Athens 17675, Greece

[12] NEPHROEXPERT Athens Kidney Inst, Athens, Greece

来源：

JOURNAL OF CLINICAL MEDICINE | 2024年 / 13卷 / 14期

关键词：

Mediterranean diet; magnesium; hemodialysis; peritoneal dialysis; mortality; cardiovascular; CHRONIC KIDNEY-DISEASE; CLINICAL-PRACTICE GUIDELINE; PERITONEAL-DIALYSIS; BONE DISORDER; UPDATE; HYPOMAGNESEMIA; METAANALYSIS; DEPLETION; ADEQUACY; TRIAL;

D O I：

10.3390/jcm13144024

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Hypomagnesaemia is associated with an increased overall mortality in patients with chronic kidney disease on dialysis (CKD-5D). Mediterranean-style diet (MD), having a high magnesium content, can serve as a form of dietary magnesium supplementation. We examined whether there is a potential link between increased Mediterranean Diet score (MDS) and elevated serum magnesium (sMg) to assess its impact on reducing mortality risk in CKD-5D patients. Methods: In this multi-center prospective observational study, 117 CKD-5D patients (66 on hemodialysis and 51 on peritoneal dialysis) with a mean age of 62 +/- 15 years were studied for a median follow-up period of 68 months. After baseline assessment, including measurement of sMg and MDS, all patients were followed up for cardiovascular (CV) and all-cause mortality. Results: Forty deaths occurred, 58% of which were cardiovascular. Patients who were above the median value of sMg (2.2 mg/dL) had a 66% reduction in CV (crude HR, 0.34; 95% CI, 0.11-0.70), and 49% reduction in all-cause (crude HR, 0.51; 95% CI, 0.27-0.96) mortality, even after adjustment for age, malnutrition inflammation score, left ventricular mass index, peripheral vascular disease and diabetes. Similar results were obtained when sMg was analyzed as a continuous variable. sMg was associated directly with MDS (r = 0.230; p = 0.012). Conclusions: Higher sMg levels are strongly and independently associated with reduced CV and all-cause mortality in CKD-5D patients. A strong correlation exists between MDS and sMg. Elevated sMg levels, achieved through MD adherence, can significantly reduce CV mortality, implicating MD as a mediator of the association between sMg and CV mortality.

引用

页数：14