Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Conduct
2.3. Inclusion and Exclusion Criteria
2.4. Treatment Groups
2.5. Endpoint Analysis
2.6. Matching
2.7. Statistical Analysis
3. Results
4. Discussion
Acknowledgments
Author Contributions
Conflicts of Interest
Appendix A
Predictor | Unit | Hazard Ratio (95% CI) | p-Value |
---|---|---|---|
Age * | 1 year | 1.06 (1.02, 1.10) | 0.002 |
Gender | Male | 1.92 (0.76, 4.88) | 0.17 |
CCI * | 1 | 2.75 (1.80, 4.20) | <0.001 |
Smoking status | Smoker | 0.04 (0.00, 3.94) | 0.17 |
BMI | 1 kg/m2 | 1.04 (0.98, 1.11) | 0.24 |
Kt/V | 1 | 0.34 (0.12, 0.99) | 0.047 |
Total cholesterol | 1 mg/dL | 0.99 (0.98, 1.00) | 0.14 |
LDL cholesterol | 1 mg/dL | 0.99 (0.98, 1.01) | 0.25 |
Predictor | Unit | Regression Coefficient | Hazard Ratio (95% CI) | p-Value |
---|---|---|---|---|
Dialysate group | High dialysate magnesium | −1.06 | 0.35 (0.13, 0.97) | 0.044 |
Age | 1 year | 0.04 | 1.04 (1.00, 1.09) | 0.08 |
CCI * | 1 | 0.96 | 2.60 (1.58, 4.28) | <0.001 |
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Dialysate Magnesium | |||
---|---|---|---|
High 0.75 mmol/L (n = 25) | Low 0.50 mmol/L (n = 50) | p-Value | |
Age (years) | 66.3 (48.5–73.5) | 67.9 (49.2–73.9) | 0.86 |
Gender (males) | 16 (64.0) | 32 (64.0) | 1.0 |
BMI (kg/m2) | 28.1 (25.0–34.7) | 24.4 (22.2–29.2) | 0.034 |
Follow-up (days) | 1121 (1047.5–1138.5) | 1200 (550.8–1200.0) | 0.06 |
Dialysis vintage (months) | 41.0 (30.0–96.5) | 47.0 (26.5–99.3) | 0.86 |
Ultrafiltration rate per hour | 563.6 ± 283.0 | 478.7 ± 263.5 | 0.37 |
Volume reduction per session (L) | 1.9 ± 1.7 | 1.6 ± 1.2 | 0.37 |
Kt/V | 1.53 ± 0.29 | 1.37 ± 0.43 | 0.07 |
Dialysis duration per session (h) | 4.5 (4.0–4.5) | 4.2 (4.0–4.5) | 0.88 |
Systolic arterial pressure (mmHg) | 137.7 ± 18.1 | 129.9 ± 27.0 | 0.20 |
Diastolic arterial pressure (mmHg) | 66.7 ± 17.1 | 68.5 ± 13.3 | 0.63 |
Ionized magnesium in serum (mmol/L) | 0.64 ± 0.12 | 0.57 ± 0.10 | 0.034 |
Phosphate (mmol/L) | 1.53 (1.37–1.94) | 1.75 (1.40–2.11) | 0.16 |
Total calcium in serum (mmol/L) | 2.28 ± 0.24 | 2.27 ± 0.20 | 0.89 |
Ionized calcium in serum (mmol/L) | 1.22 ± 0.18 | 1.21 ± 0.13 | 0.86 |
Calcium x phosphate (mmol2/L2) | 3.78 (2.87–4.51) | 3.90 (3.14–4.74) | 0.23 |
Alkaline phosphatase (U/L) | 74 (56–90) | 88 (66–113) | 0.10 |
Intact parathyroid hormone (pg/mL) | 152.48 (51.00–189.50) | 191.10 (86.55–361.00) | 0.11 |
High resolution CRP (mg/L) | 0.68 (0.16–1.28) | 0.55 (0.16–1.37) | 0.94 |
Albumin (g/dL) | 3.94 (3.78–4.33) | 3.96 (3.70–4.10) | 0.24 |
Blood urea nitrogen (mg/dL) | 59.48 ± 16.61 | 63.23 ± 17.37 | 0.70 |
Hematocrit (%) | 35.74 ± 4.29 | 34.69 ± 4.79 | 0.34 |
Haemoglobin (g/dL) | 11.72 ± 1.35 | 11.61 ± 1.45 | 0.74 |
Total cholesterol (mg/dL) | 167.0 ± 48.2 | 190.0 ± 48.5 | 0.08 |
HDL cholesterol (mg/dL) | 41.0 (37.8–55.8) | 45.0 (37.8–55.8) | 0.21 |
LDL cholesterol (mg/dL) | 91.1 ± 39.4 | 117.8 ± 36.6 | 0.012 |
Charlson Comorbidity Index (1–4) | 1.0 (0–1.5) | 1.0 (0–1.0) | 0.27 |
Diabetes mellitus | 16 (64.0) | 24 (48.0) | 0.23 |
History of myocardial infarction | 7 (28.0) | 12 (24.0) | 0.78 |
Peripheral artery disease | 9 (36.0) | 14 (28.0) | 0.60 |
Smoking (ever) | 4 (16.0) | 8 (16.0) | 1.0 |
Predictor | Unadjusted | Adjusted * | ||
---|---|---|---|---|
Hazard Ratio (95% CI) | p-Value | Hazard Ratio (95% CI) | p-Value | |
High dialysate magnesium | 0.54 (0.20, 1.46) | 0.24 | 0.35 (0.13, 0.97) | 0.044 |
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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.; et al. Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study. Nutrients 2017, 9, 926. https://doi.org/10.3390/nu9090926
Schmaderer C, Braunisch MC, Suttmann Y, Lorenz G, Pham D, Haller B, Angermann S, Matschkal J, Renders L, Baumann M, et al. Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study. Nutrients. 2017; 9(9):926. https://doi.org/10.3390/nu9090926
Chicago/Turabian StyleSchmaderer, Christoph, Matthias C. Braunisch, Yana Suttmann, Georg Lorenz, Dang Pham, Bernhard Haller, Susanne Angermann, Julia Matschkal, Lutz Renders, Marcus Baumann, and et al. 2017. "Reduced Mortality in Maintenance Haemodialysis Patients on High versus Low Dialysate Magnesium: A Pilot Study" Nutrients 9, no. 9: 926. https://doi.org/10.3390/nu9090926