Even though disorders of magnesium (Mg) balance are common in dialyzed patients, this cation is often neglected. Many factors interfere with serum magnesium including diet, medications (eg, antacids or phosphate binders), and the dialysis prescription. Mg supplementation may help reduce serum phosphate concentration, PTH, and interfere with vascular calcification and bone mineralization. It could also decrease the all-cause and cardiovascular mortalities, although the results of current studies are conflicting. As with many other variables that influence hard endpoints in nephrology, additional research directly targeting the role of Mg supplementation in dialyzed patients are required. Nevertheless, a current risk/benefit assessment suggests that supplementation of Mg targeting high normal serum levels may represent a plausible option to improve the outcome of dialysis patients.
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