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. 2019 Dec;21(12):1172-1180.
doi: 10.1177/1098612X18823588. Epub 2019 Jan 29.

Total serum magnesium in cats with chronic kidney disease with nephrolithiasis

Fernanda Chicharo Chacar  1 , Marcia Mery Kogika  1 , Andréa C Ferreira  1 , Khadine K Kanayama  1 , Archivaldo Reche  1
Affiliations

Total serum magnesium in cats with chronic kidney disease with nephrolithiasis

Fernanda Chicharo Chacar et al. J Feline Med Surg. 2019 Dec.

Abstract

Objectives: Magnesium has been 'the forgotten ion' for many years. Over the past decade, however, the role of magnesium in essential physiological functions and several illness conditions have been elucidated. Nevertheless, the investigation of magnesium in cats with chronic kidney disease (CKD) and nephrolithiasis is yet to be determined. The purpose of this study was to investigate whether CKD cats with nephrolithiasis have changes in total serum magnesium concentrations, and whether magnesium disorders may be associated with other electrolyte disturbances, as well as with prognosis. We also aimed to evaluate whether total serum magnesium concentration differs between CKD cats with and without nephrolithiasis.

Methods: Total serum magnesium concentrations were assessed in 42 cats with CKD with stage 1-4 nephrolithiasis. The correlation between magnesium and other electrolytes, as well as Kaplan-Meier survival analysis, were performed. We also selected 14 control cats with CKD without nephrolithiasis age-matched with 14 cats with CKD with nephrolithiasis.

Results: Hypermagnesemia was observed in 16/42 (38.1%) and hypomagnesemia in 6/42 (14.3%) cats. Serum magnesium abnormalities were observed in cats of all stages, and marked hypermagnesemia was noted in cats with stage 4 CKD with nephrolithiasis (P <0.001). There was a negative correlation between total serum magnesium and ionized calcium (r = -0.64; P <0.01), and a positive correlation between total serum magnesium and serum phosphorus (r = 0.58, P = 0.01). Cats with CKD with nephrolithiasis and hypomagnesemia or hypermagnesemia had higher mortality than those with normal total serum magnesium concentration (P <0.01), regardless of CKD stage. There was no difference in total serum magnesium concentration between CKD cats with and without nephrolithiasis.

Conclusions and relevance: Cats with CKD with nephrolithiasis have magnesium abnormalities. Hypomagnesemia and hypermagnesemia were associated with an increase in mortality, and thus total serum magnesium abnormalities may be used as prognostic factors in these cases.

Keywords: Magnesium; electrolytes; mortality; nephrolithiasis; renal insufficiency.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Total serum magnesium concentrations (mean ± SD) of healthy cats and cats with chronic kidney disease (CKD) with nephrolithiasis
Figure 2
Figure 2
Blood ionized calcium levels of cats chronic kidney disease with nephrolithiasis and normal, hypo- and hypermagnesemia reference intervals (Veterinary Teaching Hospital of the University of Sao Paulo): total serum magnesium 1.58–2.16 mg/dl; ionized calcium 1.1–1.4 (mmol/l). *P <0.05; **P <0.01
Figure 3
Figure 3
(a) Spearman correlation between total serum magnesium concentrations and blood ionized calcium levels (r = −0.64; P <0.01). (b) Pearson correlation between total serum magnesium and serum phosphorus concentrations (r = 0.58, P = 0.01)
Figure 4
Figure 4
Kaplan–Meier curves of cats with chronic kidney disease with nephrolithiasis and normal, high and low total serum magnesium concentrations
Figure 5
Figure 5
Survival of cats with stage 1–4 chronic kidney disease (CKD) with nephrolithiasis, and high, low or normal total serum magnesium concentrations. (a) Cats with stage 1 CKD with nephrolithiasis; (b) cats with stage 2 CKD with nephrolithiasis; (c) cats with stage 3 CKD with nephrolithiasis; (d) cats with stage 4 CKD with nephrolithiasis
Figure 6
Figure 6
Total serum magnesium concentrations (mg/dl) of stage and age-matched cats with chronic kidney disease with and without nephrolithiasis
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