#5443 ASSOCIATION OF SERUM CALCIUM-TO-MAGNESIUM RATIO WITH CARDIOVASCULAR AND CEREBRAL VASCULAR DISEASES IN DIALYSIS PATIENTS

Abstract

Abstract Background and Aims Cardiovascular disease (CVD) and cerebral vascular accident (CVA) are the important complications and the leading causes of death in dialysis patients. High serum calcium (Ca) level promotes the clotting cascades and vascular calcification, which leads to CVD and CVA. Magnesium (Mg) is a well-known Ca blocker, inhibiting the formation of thrombin. An imbalance between serum Ca and Mg levels has been reported as an associated factor with CVD and mortality. This study investigated the associations of serum Ca-Mg ratio with CVD and CVA in dialysis patients. Method We conducted a cross-sectional analysis using baseline data from a multicenter prospective cohort for dialysis patients in South Korea. A total of 860 patients were divided into tertile groups according to serum Ca-Mg ratio levels. Patients with serum Ca-Mg ratio less than 3.28 were classified as the low group, and patients with serum Ca-Mg ratio more than 3.87 were classified as the high group, and the rest were classified as the middle group. Serum Ca level was calculated and applied as corrected Ca level considering serum albumin level. The associations of serum Ca-Mg ratio with prevalence of acute coronary syndrome (ACS), congestive heart failure, aortic artery calcification, and CVA were assessed. Results The average age of all patients was 59.1±12.1 years, and the average duration of dialysis was 7.9±5.9 years, and the duration of the low group was shorter than those of other groups. The high group had higher prevalence of peripheral vascular disease (P = 0.004). Serum albumin, phosphorus and Mg levels in the high group were lower than other groups (P<0.001). The prevalence of ACS showed higher in the high group than in other groups (P = 0.017). The prevalence of cerebral infarction showed higher in the high group than the low group (P = 0.016). In multivariable logistic regression analysis, higher Ca-Mg ratio was independently associated with the prevalence of ACS (Odds ratio 1.321, 95% confidential interval 1.009-1.728, P = 0.043) and cerebral infarction (Odds ratio 1.392, 95% confidential interval 1.002-1.896, P = 0.036). Conclusion A high Ca-Mg ratio was associated with the development of ACS and cerebral infarction. If the optimal cut-off of Ca-Mg ratio is determined, it can be used as a predictive marker for ACS and cerebral infarction.