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Impact of serum magnesium and bone mineral density on systemic fractures in chronic hemodialysis patients.
- Source :
-
PloS one [PLoS One] 2021 May 20; Vol. 16 (5), pp. e0251912. Date of Electronic Publication: 2021 May 20 (Print Publication: 2021). - Publication Year :
- 2021
-
Abstract
- Introduction: Bone mineral density (BMD) measured with dual-energy X-ray absorptiometry (DXA) can be used to predict fractures, but its clinical utility has not been fully established in chronic kidney disease (CKD) patients. Magnesium is an essential trace element. Although magnesium is associated with the risk of fractures in non-CKD populations, the relationship is unknown in CKD patients.<br />Methods: BMD and serum magnesium levels were measured in 358 stable outpatients undergoing maintenance hemodialysis therapy. The primary outcome was fragility fracture. Patients were divided into groups according to the median level of magnesium and the normal threshold value of lumbar spine BMD.<br />Results: During the median follow-up period of 36 months, 36 (10.0%) fractures occurred. The cumulative incidence rates of fractures were 17.6% and 5.2% [adjusted hazard ratio (aHR) 2.31, 95% confidence interval (CI) 1.03-5.17, P = 0.030] in the lower (<2.6 mg/dL) and higher (≥2.6 mg/dL) magnesium (Mg) groups, respectively, and 21.2% and 7.3% (aHR 2.59, 95% CI 1.09-6.16, P = 0.027) in the low- and high-BMD groups, respectively. The lower-Mg and low-BMD group had a 9.21-fold higher risk of fractures (95% CI; 2.35-47.00; P = 0.0010) than the higher-Mg and high-BMD group. Furthermore, adding both magnesium levels and lumbar spine BMD levels to the established risk factors significantly improved the prediction of fractures (C-index: 0.784 to 0.830, p = 0.041).<br />Discussion/conclusions: The combination of serum magnesium and lumbar spine BMD can be used for fracture risk stratification and synergistically improves the prediction of fractures in CKD patients.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Absorptiometry, Photon
Aged
Bone Density physiology
Female
Fractures, Bone complications
Fractures, Bone epidemiology
Fractures, Bone physiopathology
Humans
Male
Middle Aged
Renal Dialysis adverse effects
Renal Insufficiency, Chronic complications
Renal Insufficiency, Chronic physiopathology
Renal Insufficiency, Chronic therapy
Fractures, Bone blood
Magnesium blood
Renal Insufficiency, Chronic blood
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 16
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 34014999
- Full Text :
- https://doi.org/10.1371/journal.pone.0251912