The Japanese Journal of Clinical Dialysis Vol.35 No.2(10)

Theme Electrolyte and acid-base disorders in dialysis patients
Title Seeking for the optimal range of serum magnesium levels among dialysis patients
Publish Date 2019/02
Author Yusuke Sakaguchi Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine
[ Summary ] While life-threatening hypermagnesemia must be avoided in patients undergoing dialysis therapy, recent cohort studies have reported that patients with mild hypermagnesemia showed the best prognosis. Since experimental studies have demonstrated that magnesium prevents the progression of vascular calcification, mildly elevated magnesium levels might be beneficial for hemodialysis patients who have a high risk of vascular calcification. Importantly, an ionized fraction of circulating magnesium is reduced in hemodialysis patients possibly because of an accumulation of anions, such as phosphate, that are complexed with magnesium. As a result, ionized magnesium concentrations in hemodialysis patients are mostly within a normal range. Thus, there might be an opportunity to use a high magnesium dialysate. Future interventional studies are warranted to elucidate the optimal range of magnesium levels for dialysis patients.
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