John Libbey Eurotext

Magnesium Research


Magnesium-based interventions for normal kidney function and chronic kidney disease Volume 29, numéro 4, December 2016

1 Division of Nephrology, Ambroise Paré Universty Hospital, University of Paris Ouest - Versailles-Saint-Quentin-en-Yvelines (UVSQ), Boulogne Billancourt/ Paris, and Inserm U-1018, Centre de recherche en épidémiologie et santé des populations (CESP), Equipe 5, Villejuif, France
2 Nephrology Department, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
3 ERBP, Ghent University Hospital, Ghent, Belgium
4 Department of Cardiology and Intensive Care Medicine, RWTH University Hospital Aachen, Aachen, Germany
5 Department of Nephrology, Fundació Puigvert, IIB Sant Pau, REDinREN, Barcelona, Spain
6 Department of Medicine, Division of Nephrology, Dialysis and Renal Transplantation, University Hospital Leuven, Leuven, Belgium
7 King's Health Partners, AHSC, London, UK
8 Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
9 Department of Nephrology and Dialysis, Ramsay-Générale de Santé, Clinique du Landy, and Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris, France
10 Department of Nephrology and Institute for Cardiovascular Research VU, VU University Medical Center, Amsterdam, Netherlands
11 Department of Health Sciences, Renal Division, San Paolo Hospital, University of Milan, Milan, Italy
* Correspondence: Ziad A. Massy. Ambroise Paré Hospital, Paris-Ile-de-France-Ouest University (UVSQ) 9 avenue Charles de Gaulle, 92104 Boulogne Billancourt cedex France

Magnesium (Mg) is one of the most important cations in the body, playing an essential role in biological systems as co-factor for more than 300 essential enzymatic reactions. In the general population, low levels of Mg are associated with a high risk of cardio-vascular disease (CVD). Despite the accumulating literature data, the effect of Mg administration on mortality in chronic kidney disease (CKD) patients has never been investigated as a primary end-point. We conducted a systematic search of studies assessing the benefits and harms of Mg in CKD (stages 1 to 5 and 5D), and considered all randomized controlled trials (RCTs) and quasi-RCTs evaluating Mg-based interventions in CKD. As a phosphate binder, Mg salts offer a plausible opportunity for doubly favorable effects via reduction of intestinal phosphate absorption and addition of potentially beneficial effects via increasing circulating Mg levels. Mg supplementation might have a favorable effect on vascular calcification, although evidence for this is very slight. Although longitudinal data describe an association between low serum Mg levels and increased total and cardiovascular mortality, in patients with CKD, the existing RCTs reporting the effect of Mg supplementation on mortality failed to demonstrate any favorable effect. As with many other variables that influence hard end-points in nephrology, the role of Mg in CKD patients needs to be investigated in more depth. Additional research that is well-designed and directly targeting the role of Mg is needed as a consequence of limited existing evidence.