Hypomagnesemia in Type 2 Diabetic Nephropathy: A novel predictor of end-stage renal disease

• Published in: Diabetes care Vol. 35; no. 7; pp. 1591 - 1597
• Main Authors: SAKAGUCHI, Yusuke, SHOJI, Tatsuya, RAKUGI, Hiromi, TSUBAKIHARA, Yoshiharu, HAYASHI, Terumasa, SUZUKI, Akira, SHIMIZU, Morihiro, MITSUMOTO, Kensuke, KAWABATA, Hiroaki, NIIHATA, Kakuya, OKADA, Noriyuki, ISAKA, Yoshitaka
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.07.2012
• Subjects: Aged; Biological and medical sciences; Cardiovascular disease; Chronic kidney failure; Cohort Studies; Development and progression; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes. Impaired glucose tolerance; Diabetic nephropathies; Diabetic Nephropathies - complications; Disease Progression; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Kidney diseases; Kidney Failure, Chronic - etiology; Kidneys; Magnesium - blood; Magnesium Deficiency - complications; Magnesium deficiency diseases; Male; Medical research; Medical sciences; Medicine, Experimental; Metabolic diseases; Metals (hemochromatosis...); Middle Aged; Miscellaneous; Original Research; Other metabolic disorders; Public health. Hygiene; Public health. Hygiene-occupational medicine; Renal Insufficiency, Chronic - complications; Retrospective Studies; Rodents; Survival Analysis; Type 2 diabetes; Endocrinopathy; Kidney disease; Type 2 diabetes; Human; Hydroelectrolytic balance disorder; Urinary system disease; Chronic renal failure; Nutrition; Prediction; Metabolic diseases; Inorganic element; Metabolic disorder; Nephropathy; Magnesium; Predictive factor; Endocrinology; Hypomagnesemia
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc12-0226

There is now growing evidence that magnesium (Mg) deficiency is implicated in type 2 diabetes and its complications. However, it has not been fully elucidated whether hypomagnesemia is a predictor of end-stage renal disease (ESRD) in type 2 diabetic nephropathy. This retrospective cohort study included 455 chronic kidney disease (CKD) patients (144 with type 2 diabetic nephropathy and 311 with nondiabetic CKD) who were hospitalized at Osaka General Medical Center for a CKD educational program between April 2001 and December 2007. The primary outcome was progression to renal replacement therapy. Participants were categorized based on serum Mg level into Low-Mg (serum Mg level ≤1.8 mg/dL) and High-Mg (serum Mg level >1.8 mg/dL) groups with the previously published normal lower limit chosen as the cutoff point. Of the subjects with type 2 diabetic nephropathy, 102 progressed to ESRD during follow-up (median, 23 months). A multivariate Cox proportional hazards model showed that after adjustment for various demographic factors and laboratory data, the Low-Mg group had a 2.12-fold higher risk of ESRD than the High-Mg group (95% CI 1.28-3.51; P = 0.004). In contrast, 135 of the nondiabetic CKD subjects progressed to ESRD during follow-up (median, 44 months). No significant difference in outcome was found between the Low- and High-Mg groups of this population (adjusted hazard ratio, 1.15; 95% CI 0.70-1.90; P = 0.57). Hypomagnesemia is a novel predictor of ESRD in patients with type 2 diabetic nephropathy.