TY - JOUR
T1 - The effect of increasing dialysate magnesium on serum calcification propensity in subjects with end stage kidney disease
T2 - A randomized, controlled clinical trial
AU - Bressendorff, Iain
AU - Hansen, Ditte
AU - Schou, Morten
AU - Pasch, Andreas
AU - Brandi, Lisbet
PY - 2018
Y1 - 2018
N2 -
Background and objectives Serum calcification propensity is a novel functional test that quantifies the functionality of the humeral system of calcification control. Serum calcification propensity is measured by T
50
, the time taken to convert from primary to secondary calciprotein particle in the serum. Lower T
50
represents higher calcification propensity and is associated with higher risk of cardiovascular events and death in patients with ESKD. Increasing magnesium in serum increases T
50
, but so far, no clinical trials have investigated whether increasing serum magnesium increases serum calcification propensity in subjects with ESKD. Design, setting, participants, & measurements We conducted a single-center, randomized, double-blinded, parallel group, controlled clinical trial, in which we examined the effect of increasing dialysate magnesium from 1.0 to 2.0 mEq/L for 28 days compared with maintaining dialysate magnesium at 1.0 mEq/L on T
50
in subjects undergoing hemodialysis for ESKD. The primary end point was the value of T
50
at the end of the intervention. Results Fifty-nine subjects were enrolled in the trial, and of these, 57 completed the intervention and were analyzed for the primary outcome. In the standard dialysate magnesium group, T
50
was 233±81 minutes (mean±SD) at baseline (mean of days-7 and 0) and 229±93 minutes at follow-up (mean of days 21 and 28), whereas in the high dialysate magnesium group, T
50
was 247±69 minutes at baseline and 302±66 minutes at follow-up. The difference in T
50
between the two groups at follow-up (primary analysis) was 73 minutes (between-group difference; 95% confidence interval, 30 to 116; P<0.001), and the between-group difference in serum magnesium was 0.88 mg/dl (95% confidence interval, 0.66 to 1.10; P=0.001). Conclusions Increasing dialysate magnesium increases T
50
and hence, decreases calcification propensity in subjects undergoing maintenance hemodialysis.
AB -
Background and objectives Serum calcification propensity is a novel functional test that quantifies the functionality of the humeral system of calcification control. Serum calcification propensity is measured by T
50
, the time taken to convert from primary to secondary calciprotein particle in the serum. Lower T
50
represents higher calcification propensity and is associated with higher risk of cardiovascular events and death in patients with ESKD. Increasing magnesium in serum increases T
50
, but so far, no clinical trials have investigated whether increasing serum magnesium increases serum calcification propensity in subjects with ESKD. Design, setting, participants, & measurements We conducted a single-center, randomized, double-blinded, parallel group, controlled clinical trial, in which we examined the effect of increasing dialysate magnesium from 1.0 to 2.0 mEq/L for 28 days compared with maintaining dialysate magnesium at 1.0 mEq/L on T
50
in subjects undergoing hemodialysis for ESKD. The primary end point was the value of T
50
at the end of the intervention. Results Fifty-nine subjects were enrolled in the trial, and of these, 57 completed the intervention and were analyzed for the primary outcome. In the standard dialysate magnesium group, T
50
was 233±81 minutes (mean±SD) at baseline (mean of days-7 and 0) and 229±93 minutes at follow-up (mean of days 21 and 28), whereas in the high dialysate magnesium group, T
50
was 247±69 minutes at baseline and 302±66 minutes at follow-up. The difference in T
50
between the two groups at follow-up (primary analysis) was 73 minutes (between-group difference; 95% confidence interval, 30 to 116; P<0.001), and the between-group difference in serum magnesium was 0.88 mg/dl (95% confidence interval, 0.66 to 1.10; P=0.001). Conclusions Increasing dialysate magnesium increases T
50
and hence, decreases calcification propensity in subjects undergoing maintenance hemodialysis.
U2 - 10.2215/CJN.13921217
DO - 10.2215/CJN.13921217
M3 - Journal article
C2 - 30131425
AN - SCOPUS:85053304958
SN - 1555-9041
VL - 13
SP - 1373
EP - 1380
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 9
ER -