Do diabetes and nutrition status determine plasma magnesium concentration in patients on chronic renal replacement therapy?

Abstract

Introduction. Magnesium depletion negatively impacts the cardiovascular system, inflammation, insulin resistance and diabetes – in patients on chronic haemodialysis it is linked to worse prognosis and inflammation, and the magnesaemia correlates with protein intake (nPCR) and creatininaemia. Aim. To verify which elements of the standard set of clinical data used for assessment of nutrition status, correlate best with plasma magnesium in diabetic and non-diabetic patients on chronic haemodialysis program. Material and methods. Single-unit observational study, based on standard laboratory and clinical parameters obtained at the beginning of a single midweek haemodialysis session for routine cyclic workup in patients on regular chronic haemodialysis. Results. Out of 147 adult patients on regular chronic haemodialysis (males 83, females 64; median age 68 years) 57 had diabetes. Hypomagnesaemia was diagnosed in 2 (1.19%), and hypermagnesaemia in 39 (23.21%). Serum magnaesium concentration was < 0.83 mmol/l in 32 patients (21.77%) – 16 with, and 16 without diabetes (28 and 17.8% of all patients with and without diabetes, respectively). The only variables correlating with magnesaemia were nPCR, plasma creatinine and albumin (R2 = 0.32). Within each tertile of magnesaemia, none of the predialysis blood parameters analysed differed in patients with diabetes from that in patients with no diabetes, with an exception for urea and phosphate concentrations, higher in patients with diabetes within the tertile 2. Conclusions. Better diet results in better nutrition and higher magnesium serum concentration in haemodialysis patients, which might prevent, or diminish inflammation also in patient with diabetes. The efficacy of dialysis seemed of lesser importance.