Association between hypomagnesemia and mortality among dialysis patients: a systematic review and meta-analysis

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Title:	Association between hypomagnesemia and mortality among dialysis patients: a systematic review and meta-analysis
Authors:	Huang, Chi-Ya Yang, Chi-Chen Hung, Kuo-Chuan Jiang, Ming-Yan Huang, Yun-Ting Hwang, Jyh-Chang Hsieh, Chih-Chieh Chuang, Min-Hsiang Chen, Jui-Yi
Contributors:	Chi Mei Hospital Chi Mei Hospital Chi Mei Hospital Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy & Science Department of Health and Nutrition, Chia Nan University of Pharmacy & Science
Keywords:	cardiovascular risk-factors serum magnesium levels hemodialysis-patients significant predictor
Date:	2022
Issue Date:	2023-12-11 14:04:50 (UTC+8)
Publisher:	PEERJ INC
Abstract:	Background: Malnutrition-inflammation-atherosclerosis (MIA) syndrome is caused by the inflammatory cytokines in end stage renal disease (ESRD) patients, and MIA complex-related factors may be associated with hypomagnesemia and mortality. However, the association between serum magnesium level and mortality for dialysis patients is still not clear. Additionally, no meta-analysis has investigated the impact of serum magnesium on peritoneal dialysis and hemodialysis, separately. Methods: We searched published studies in PubMed, Embase, Cochrane, Collaboration Central Register of Controlled Clinical Trials, and Cochrane Systematic Reviews through April 2022. Studies associated with serum magnesium and all-cause mortality or cardiovascular (CV) mortality in ESRD on kidney replacement therapy (KRT) patients were included. A hazard ratio (HR) with 95% confidence intervals (CI) was used to report the outcomes. Results: Twenty-one studies involving 55,232 patients were included. Overall, there was a significant association between hypomagnesemia and all-cause mortality for dialysis patients (HR: 1.67, 95% CI [1.412-2.00], p < 0.001; certainty of evidence: moderate) using a mixed unadjusted and adjusted HR for analysis. There was also a significantly increased risk of CV mortality for individuals with hypomagnesemia compared with the non-hypomagnesemia group (HR 1.56, 95% CI [1.08-2.25], p < 0.001; certainty of evidence: moderate). In addition, a subgroup analysis demonstrated that hypomagnesemia was associated with a high risk of both all-cause mortality and CV mortality (all-cause mortality, HR:1.80, 95% CI [1.48-2.19]; CV mortality, HR:1.84, 95% CI [1.10-3.07]) in hemodialysis (HD) patients, but not in participants receiving peritoneal dialysis (PD; all-cause mortality, HR:1.26, 95% CI [0.84-1.91]; CV mortality, HR:0.66, 95% CI [0.22-2.00]). The systematic review protocol was prespecified and registered in PROSPERO [CRD42021256187]. Conclusions: Hypomagnesemia may be a significant risk factor for all-cause mortality and CV mortality in KRT patients, especially in those receiving hemodialysis. However, because of the limited certainty of evidence, more studies are required to investigate this association.
Relation:	PeerJ, v.10
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles [Dept. of Health and Nutrition (including master's program)] Periodical Articles

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