Magnesium and Mortality in Patients with Diabetes and Early Chronic Kidney Disease

Objective: Cardiovascular disease is extensively described as being associated with chronic kidney disease, representing the most important cause of morbidity and mortality in these patients. Recent studies have suggested that hypomagnesaemia may be involved in the pathogenesis of cardiovascular disease in chronic kidney disease patients. Methods: An observational, prospective study involving 191 diabetic patients at chronic kidney disease stages 1-3 divided into groups according to baseline levels of magnesium; 1: < 1.2 mg/dL, 2: 1.2-2.3 mg/dL and 3: >= 2.3 mg/dL. Different serum parameters were analyzed and compared between Mg levels. Carotid eco-Doppler and transthoracic echocardiography were also used to assess calcification features Statistical tests were used to find predictors of cardiovascular mortality, hospitalizations and disease progression. Results: Patients' survival at 54 months in group 1, 2 and 3 was 27.8%, 73.8% and 80.2%, respectively (p<0.001). Magnesium was found to be an independent predictor of both mortality and hospitalizations, with a statistically significant decrease in mortality and hospitalizations observed at higher levels of magnesium. Magnesium levels were also negatively correlated with known cardiovascular risk factors and with serum creatinine. Patients with lower magnesium level were more likely to start a renal replacement therapy. Conclusions: Lower magnesium levels result in a greater risk of cardiovascular mortality and hospitalization as well as an accelerated progression of renal disease to renal replacement therapy.