scholarly journals Serum magnesium and its association with vascular calcification in chronic kidney disease patients on haemodialysis

Author(s):  
Prasanna K. B. ◽  
Sharavanan T. V. K. ◽  
Ekanthalingam S. ◽  
Kannan I.

Background: Cardiovascular disease is one of the leading causes of death in chronic kidney disease (CKD). It has been observed that haemodialysis patients have a high prevalence of cardiac risk factors with further risk due to abnormal mineral metabolism. A study has demonstrated that a higher serum magnesium significantly decreased the mortality risk in haemodialysis patients and lower serum Mg level has been found to be associated with increased mortality in them. The aim of the study was to characterize the relationship between Mg level and vascular calcification in CKD patients.Methods: It was a cross sectional study conducted in 100 CKD patients attending outpatient and inpatient ward of Tagore Medical College and Hospital, Chennai, Tamil Nadu, India. Serum magnesium levels will be measured using Xylidyl blue method. Carotid intimal medial thickness will be measured using Doppler.Results: In the study 10 patients did not show the sign of any calcification. Among the remaining 90 patients, 42 patients showed calcification and 48 patients showed stenosis. The statistical analysis showed a spearman correlation coefficient value of 0.201 thus showing only a weak association.Conclusion: The present study showed that only a weak relationship exists between the magnesium level and vascular calcification.

2020 ◽  
Author(s):  
Raimunda Sheyla Carneiro Dias ◽  
Dyego José Araújo Brito ◽  
Joyce Santos Lages ◽  
Alcione Miranda Santos ◽  
Elisangela Milhomen Santos ◽  
...  

Abstract Background: Disorders of mineral metabolism occur in most patients with chronic kidney disease (CKD). The aim of this work was to correlate serum parathyroid hormone (PTH) levels with urinary magnesium excretion in patients with non-dialysis CKD. Methods: Cross-sectional study with patients with CKD undergoing non-dialysis treatment in stages 3A, 3B and 4. Concentrations of creatinine, magnesium, calcium, phosphorus, parathyroid hormone, vitamin D and alkaline phosphatase were determined in blood samples. The assessment of urinary magnesium levels was performed by means of total daily excretion and by the excretion fraction (FEMg). Results: The study evaluated 163 patients with mean age of 60.7 ± 11.7 and 51.0% were male. A positive correlation was observed between PTH and alkaline phosphatase (r = 0.26; p = 0.006) and FEMg (r = 0.17; p = 0.020). Calcium (r = -0.23; p = 0.002), magnesium in 24-hour urine (r = -0.18; p = 0.020) and estimated glomerular filtration rate (r = -0.47; p = 0.001) demonstrated negative correlation with PTH. Conclusion: Elevated levels of PTH correlated positively with FEMg, regardless of the presence of serum magnesium alterations, and FEMg can be used as another indicator for the treatment of hyperparathyroidism.


2020 ◽  
Author(s):  
Raimunda Sheyla Carneiro Dias ◽  
Dyego José Araújo Brito ◽  
Joyce Santos Lages ◽  
Alcione Miranda Santos ◽  
Elisangela Milhomen Santos ◽  
...  

Abstract Background: Disorders of mineral metabolism occur in most patients with chronic kidney disease (CKD). The aim of this work was to correlate serum parathyroid hormone (PTH) levels with urinary magnesium excretion in patients with non-dialysis CKD.Methods: Cross-sectional study with patients with CKD undergoing non-dialysis treatment in stages 3A, 3B and 4. Concentrations of creatinine, magnesium, calcium, phosphorus, parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D] and alkaline phosphatase (ALP) were determined in blood samples. The assessment of urinary magnesium levels was performed by means of total daily excretion and by the excretion fraction (FEMg). Results: The study evaluated 163 patients with a mean age of 60.7 ± 11.7 years and 51.0% were male. In the highest quartile of PTH (> 89.5pg / ml), the mean levels of FEMg and ALP were higher (p <0.05), as well as the levels of serum calcium and eGFR were lower (p <0.05). In the unadjusted regression analysis, the following variables were related to serum PTH levels: FEMg (odds ratio (OR) = 1.12; 95% confidence intervals (CI): 1.02–1.23), Calcium (OR = 0.45; 95% CI: 0.22-0.90), ALP (OR = 1.02; 95% CI: 1.00-1.03) and eTFG (OR = 0.92; 95% CI: 1.00-1.03). After an adjusted analysis, only one FEMg and ALP will remain correlated with PTH. Conclusion: In patients with non-dialysis CKD, with higher levels of PTH, higher mean columns of ALP and FEMg, and lower levels of serum calcium and eGFR. FEMg and ALP were some variables that remained associated with PTH.


2009 ◽  
Vol 4 (10) ◽  
pp. 1646-1654 ◽  
Author(s):  
Juan F. Navarro-González ◽  
Carmen Mora-Fernández ◽  
Mercedes Muros ◽  
Haridian Herrera ◽  
Javier García

Author(s):  
Patritius Kelik Dwi Santo Ismoyo ◽  
Sugeng Yuwana

Background: Chronic kidney disease (CKD) is associated with impairment of mineral metabolism that, in turn, may result in the derangement of bone density, i.e. osteopenia or osteoporosis. Purpose: The objective of this study is to assess the impairment of bone density in male patients underwent routine hemodialysis due to stage V CKD.Methods: Subjects in this cross sectional study were male patients underwent routine hemodialysis in Hemodialysis Unit Dr. Sardjito General Hospital Yogyakarta in June 2014. Subjects were invited when they were over 18 years old and had undergone hemodialysis for at least 6 months. Bone density of lumbar spine, total hip and femoral neck were assessed using DEXA. We collected information on age and the etiology of the CKD from medical records. Body weight and height were measured using calibrated apparatus. Data were analyzed using OpenEpi.Results: We invited 30 male patients with mean (SD) age of 56.8 (13.8) years. Bone density of lumbar spine and femoral neck were significantly associated with the duration of hemodialysis, i.e. OR (95% CI) of 31.7 (3.8-856.0), p=0.0003 and 12.0 (1.9-111.0), p=0.005, respectively for those underwent hemodialysis of more than 12 months. Obesity was only protective for the bone density of the total hip, OR(95%CI) of 0.1 (0.004-0.9), p=0.03. There was no association between the etiology of the CKD and the decrease in bone density.Conclusion: This study observed significant association between the duration of hemodialysis and bone density.


2021 ◽  
Vol 8 (7) ◽  
pp. 176-184
Author(s):  
Miftahul Ihsan ◽  
Wika Hanida Lubis ◽  
Alwi Thamrin Nasution

Objective: To assess the correlation between BDI II score as screening tools for early symptoms of depression with serum magnesium levels in regular hemodialysis patients. Methods: A cross-sectional study conducted on 48 patients with chronic kidney disease on regular HD in RSUP Haji Adam Malik. Patients included in this study were ≥ 18 years of age, on regular HD with a duration of ≥ 3 months, and were willing to be included in the study by signing a consent form after explanation. Patients with other psychiatric comorbidities other than depression and patients taking medicine that affect serum magnesium levels were excluded from the study. All studied patients were assessed for serum magnesium levels and depression symptoms using the BDI II questionnaire. Results: In this study we found that there is a significant correlation between serum Magnesium levels and BDI II score with a weak correlation strength level (r = - 0.35). The BDI II score in regular hemodialysis patients was found to be in a score of 4-15 with a median score of 7. Magnesium levels in regular hemodialysis patients ranged from 1.78 to 3.75 mg / dl, with a median of 2.9. Conclusions: In this study, there is a significant correlation found between serum Magnesium levels and BDI II score in patient on regular HD. Keywords: Beck Depression Inventory II (BD II) score, Chronic Kidney Disease, Hemodialysis, Serum magnesium levels.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Ochiai ◽  
Takako Shirasawa ◽  
Takahiko Yoshimoto ◽  
Satsue Nagahama ◽  
Akihiro Watanabe ◽  
...  

Abstract Background Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. Methods The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. Results “Elevated ALT and elevated GGT” and “elevated ALT and non-elevated GGT” significantly increased the OR for CKD when compared with “non-elevated ALT and non-elevated GGT” (OR: 2.56, 95% CI: 2.10–3.12 and OR: 2.24, 95% CI: 1.81–2.77). Compared with “AST/ALT ratio ≥ 1 and non-elevated GGT”, “AST/ALT ratio < 1 and elevated GGT” and “AST/ALT ratio < 1 and non-elevated GGT” significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36–3.15 and OR: 1.68, 95% CI: 1.52–1.87). These findings still remained after adjustment for confounders. Conclusions Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.


Biomedicines ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 19
Author(s):  
Ashani Lecamwasam ◽  
Tiffanie M. Nelson ◽  
Leni Rivera ◽  
Elif I. Ekinci ◽  
Richard Saffery ◽  
...  

(1) Background: Individuals with diabetes and chronic kidney disease display gut dysbiosis when compared to healthy controls. However, it is unknown whether there is a change in dysbiosis across the stages of diabetic chronic kidney disease. We investigated a cross-sectional study of patients with early and late diabetes associated chronic kidney disease to identify possible microbial differences between these two groups and across each of the stages of diabetic chronic kidney disease. (2) Methods: This cross-sectional study recruited 95 adults. DNA extracted from collected stool samples were used for 16S rRNA sequencing to identify the bacterial community in the gut. (3) Results: The phylum Firmicutes was the most abundant and its mean relative abundance was similar in the early and late chronic kidney disease group, 45.99 ± 0.58% and 49.39 ± 0.55%, respectively. The mean relative abundance for family Bacteroidaceae, was also similar in the early and late group, 29.15 ± 2.02% and 29.16 ± 1.70%, respectively. The lower abundance of Prevotellaceae remained similar across both the early 3.87 ± 1.66% and late 3.36 ± 0.98% diabetic chronic kidney disease groups. (4) Conclusions: The data arising from our cohort of individuals with diabetes associated chronic kidney disease show a predominance of phyla Firmicutes and Bacteroidetes. The families Ruminococcaceae and Bacteroidaceae represent the highest abundance, while the beneficial Prevotellaceae family were reduced in abundance. The most interesting observation is that the relative abundance of these gut microbes does not change across the early and late stages of diabetic chronic kidney disease, suggesting that this is an early event in the development of diabetes associated chronic kidney disease. We hypothesise that the dysbiotic microbiome acquired during the early stages of diabetic chronic kidney disease remains relatively stable and is only one of many risk factors that influence progressive kidney dysfunction.


Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.


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