Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study
AbstractBackground: Although low magnesium levels have been associated with an increased mortality in dialysis patients, they are kept low by routinely-used dialysates containing 0.50 mmol/L magnesium. Thus, we investigated the impact of a higher dialysate magnesium concentration on mortality. Methods: 25 patients on high dialysate magnesium (HDM) of 0.75 mmol/L were 1:2 matched to 50 patients on low dialysate magnesium (LDM) of 0.50 mmol/L and followed up for 3 years with regards to all-cause and cardiovascular mortality. Patients were matched according to age, gender, a modified version of the Charlson Comorbidity Index (CCI), and smoking status. Results: During the follow-up period, five patients died in the HDM and 18 patients in the LDM group. Patients in the HDM group had significantly higher ionized serum magnesium levels than matched controls (0.64 ± 0.12 mmol/L vs. 0.57 ± 0.10 mmol/L, p = 0.034). Log rank test showed no difference between treatment groups for all-cause mortality. After adjustment for age and CCI, Cox proportional hazards regression showed that HDM independently predicted a 65% risk reduction for all-cause mortality (hazard ratio 0.35, 95% confidence interval [CI]: 0.13, 0.97). Estimated 3-year probability of death from a cardiovascular event was 14.5% (95% CI: 7.9, 25.8) in the LDM group vs. 0% in the HDM group. Log rank test found a significant group difference for cardiovascular mortality (χ2 = 4.15, p = 0.042). Conclusions: Our data suggests that there might be a beneficial effect of an increased dialysate magnesium on cardiovascular mortality in chronic dialysis patients. View Full-Text
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Schmaderer, C.; Braunisch, M.C.; Suttmann, Y.; Lorenz, G.; Pham, D.; Haller, B.; Angermann, S.; Matschkal, J.; Renders, L.; Baumann, M.; Braun, J.R.; Heemann, U.; Küchle, C. Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study. Nutrients 2017, 9, 926.
Schmaderer C, Braunisch MC, Suttmann Y, Lorenz G, Pham D, Haller B, Angermann S, Matschkal J, Renders L, Baumann M, Braun JR, Heemann U, Küchle C. Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study. Nutrients. 2017; 9(9):926.Chicago/Turabian Style
Schmaderer, Christoph; Braunisch, Matthias C.; Suttmann, Yana; Lorenz, Georg; Pham, Dang; Haller, Bernhard; Angermann, Susanne; Matschkal, Julia; Renders, Lutz; Baumann, Marcus; Braun, Jürgen R.; Heemann, Uwe; Küchle, Claudius. 2017. "Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study." Nutrients 9, no. 9: 926.
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