Serum Magnesium after Kidney Transplantation: A Systematic Review

Abstract

Magnesium (Mg) status has recently drawn close attention in chronic kidney disease and in kidney transplant recipients. This review aims to evaluate the body of evidence linking hypomagnesemia to clinical consequences in these specific populations. After a brief summary of the main mechanisms involved in Mg regulation and of Mg status in end-stage renal disease, the review focuses on the relationship between hypomagnesemia and cardiovascular risk in kidney transplant recipients. A body of evidence in recent studies points to a negative impact of hypomagnesemia on post-transplant diabetes mellitus (PTDM) and cardiovascular risk, which currently represent the main threat for morbidity and mortality in kidney transplantation. Deleterious biological mechanisms induced by hypomagnesemia are also discussed. While data analysis enables us to conclude that hypomagnesemia is linked to the development of PTDM, studies prospectively evaluating the impact of hypomagnesemia correction after kidney transplantation are still lacking and needed.

Keywords: Magnesium-Kidney; diabetes after transplantation-cardiovascular risk; transplantation-New-onset.

Figure 1

Magnesium exchanges in nephron. PCT, proximal convoluted tubule; DCT, distal convoluted tubule.

Figure 2

Deleterious effects of hypomagnesaemia after kidney transplantation. Several studies support that posttransplant hypomagnesaemia increases cardiovascular (CV) risk by increasing the risk of post-transplant diabetes mellitus (PTDM) development and by favoring accelerated atherosclerosis, along with other more conventional risk factors. We suggest that hypomagnesaemia correction soon after kidney transplantation may allow to decrease CV risk and result in less CV-related morbidity and mortality in kidney transplant recipients.