John Libbey Eurotext

Magnesium Research

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Impact of sevelamer hydrochloride on serum magnesium concentrations in hemodialysis patients Volume 29, issue 4, December 2016

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Authors
1 Department of Nephrology and Dialysis, H. N. Medic Kitahiroshima, 5-6-1, Kyoeicho, Kitahiroshima 061-1113, Hokkaido, Japan
2 Department of Nephrology and Dialysis, H. N. Medic, 6-1-5, Atsubetsuchuo-5, Atsubetsu-ku, Sapporo 004-0055, Hokkaido, Japan
3 Department of Internal Medicine, H. N. Medic, 6-1-5, Atsubetsuchuo-5, Atsubetsu-ku, Sapporo 004-0055, Hokkaido, Japan
4 Department of Nephrology and Dialysis, H. N. Medic Sapporo-Higashi, 1-26, Kita-19, Higashi-7, Higashi-ku, Sapporo 065-0019, Hokkaido, Japan
* Correspondence: Ryota Ikee, MD, H. N. Medic Kitahiroshima, 5-6-1, Kyoeicho, Kitahiroshima 061-1113, Hokkaido, Japan
  • Key words: chronic kidney disease, hemodialysis, magnesium, sevelamer hydrochloride
  • DOI : 10.1684/mrh.2016.0410
  • Page(s) : 184-90
  • Published in: 2016

Serum Mg levels are elevated in patients with renal insufficiency: harmful effects of hypomagnesemia have been reported in patients receiving hemodialysis (HD). In this cross-sectional study, which included 86 HD patients (male : female = 56:30, age 68 ± 12 years), we examined the clinical factors associated with serum Mg levels, with a focus on sevelamer, a phosphate binder widely used to control the hyperphosphatemia of HD patients. The mean serum Mg concentration among our patients was 2.48 ± 0.37 mg/dL (1.02 ± 0.15 mmol/L). Sevelamer was administered to 67 patients (77.9%) at a mean dose of 1.98 ± 1.64 g/day. Sex, diabetes mellitus, cardiovascular disease, anuria, and drugs other than sevelamer were not associated with serum Mg levels. HD duration, serum calcium, albumin, high-density lipoprotein cholesterol, normalized protein catabolic rate (nPCR), creatinine generation rate, and sevelamer dose correlated positively with serum Mg levels, whereas a negative correlation was observed for age and high-sensitivity C-reactive protein. A stepwise multiple regression analysis revealed that age, nPCR, and the dose of sevelamer were independently associated with serum Mg levels. Sevelamer and Mg have been reported to exhibit similar effects, such as an anti-inflammatory effect, inhibition of cardiovascular calcification, and decreased mortality. Therefore, the pleiotropic effects of sevelamer may be partly attributable to the increase in serum Mg levels caused by the drug itself.