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Lower serum magnesium is a predictor of left ventricular hypertrophy in patients on dialysis

  • Nephrology - Original Paper
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Abstract

Purpose

Left ventricular hypertrophy (LVH) represents one of the main risk factors for cardiovascular mortality in dialysis patients. Low serum magnesium Mg is related with increased mortality in general and dialysis population. Aim of our study was to evaluate the association of Mg with LVH and cardiac geometry in dialysis patients.

Methods

Hemodialysis (HD) and peritoneal dialysis (PD) patients from nine nephrology departments were included. Echocardiographic LVH was defined by LV mass index > 95 g/m2 in women and > 115 g/m2 in men. Four LV geometric patterns were defined: normal, concentric remodeling, eccentric LVH and concentric LVH. Demographic and laboratory data were collected.

Results

133 patients (68 HD, 65 PD) with a median age of 63 years (IQR 52–74) were studied. Mg correlated positively with creatinine, HDL and negatively with CRP levels and BMI. There were no significant differences in Mg between the modality groups. 80 patients presented LVH (43 HD and 37 PD patients). Patients with LVH were older (median age 68 vs 55 years, p < 0.001), with higher BMI (median 26.9 vs 24.7 kg/m2, p = 0.009), had a history of PVD or CAD (55% vs 30.2%, p = 0.003), had higher pulse pressure (median 60 vs 50, p = 0.017), MIS score (median 5 vs 4, p = 0.011), lower albumin (median 3.5 vs 3.8 g/dl, p = 0.011) and Mg levels (median 2.1 vs 2.4 mg/dl, p < 0.001). In univariate analysis age, CVD comorbidities, pulse pressure, CRP, BMI, albumin, Mg, MIS and use of b-blockers or calcium blockers were LVH predictors. In multivariate analysis, Mg was an independent predictor of LVH, adjusted for age, MIS and b-blockers. Considering LV geometry, lower Mg levels were mainly correlated with concentric LVH.

Conclusion

Low serum magnesium levels seem to be an independent factor for LVH in hemodialysis and peritoneal dialysis patients.

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Authors and Affiliations

  1. Nephrology Department, University Hospital of Ioannina, Ioannina, Greece

    Olga Balafa & Evangelia Dounousi

  2. Medifil SA Hemodialysis Center, Athens, Greece

    Ioannis Giannikouris & Georgios Triantafyllis

  3. Nephrology Department, University Hospital of Heraklion, Heraklion, Greece

    Ioannis Petrakis

  4. Nephrology Department, General Hospital of Komotini, Komotini, Greece

    Anastasia Georgoulidou

  5. Nephrology Department, General Hospital of Prolemaida, Ptolemaida, Greece

    Despina Karassavidou

  6. Clinitest EE Hemodialysis Center, Athens, Greece

    Apostolos Kokalis

  7. IASIO Hospital, General Clinic of Kalithea, Nephrology, Athens, Greece

    Aristeidis Stauroulopoulos

  8. Nephrology Department, University Hospital of Alexandroupolis, Alexandroupolis, Greece

    Marios Theodoridis

  9. Cardiology Department, Attikon University Hospital, Athens, Greece

    Ignatios Oikonomidis

  10. Nephrology Department, Attikon University Hospital, Athens, Greece

    Ourania Tsotsorou, Kimon Tzannis & Dimitra Bacharaki

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  1. Olga Balafa
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Balafa, O., Dounousi, E., Giannikouris, I. et al. Lower serum magnesium is a predictor of left ventricular hypertrophy in patients on dialysis. Int Urol Nephrol 55, 1015–1023 (2023). https://doi.org/10.1007/s11255-022-03391-2

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