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. 2024 Jul 10;13(14):4024.
doi: 10.3390/jcm13144024.

Cardiovascular and All-Cause Mortality Is Affected by Serum Magnesium and Diet Pattern in a Cohort of Dialysis Patients

Ioannis Petrakis  1 , Dimitra Bacharaki  2 , Periklis Kyriazis  3 , Olga Balafa  4 , Evangelia Dounousi  4 , George Tsirpanlis  5 , Marios Theodoridis  6 , Ourania Tsotsorou  2 , Anastasia Markaki  7 , Anastasia Georgoulidou  8 , George Triantafyllis  9 , Ioannis Giannikouris  9 , Apostolos Kokkalis  10 , Aristeides Stavroulopoulos  11   12 , Kostas Stylianou  1
Affiliations

Cardiovascular and All-Cause Mortality Is Affected by Serum Magnesium and Diet Pattern in a Cohort of Dialysis Patients

Ioannis Petrakis et al. J Clin Med. .

Abstract

Background: Hypomagnesaemia is associated with an increased overall mortality in patients with chronic kidney disease on dialysis (CKD-5D). Mediterranean-style diet (MD), having a high magnesium content, can serve as a form of dietary magnesium supplementation. We examined whether there is a potential link between increased Mediterranean Diet score (MDS) and elevated serum magnesium (sMg) to assess its impact on reducing mortality risk in CKD-5D patients. Methods: In this multi-center prospective observational study, 117 CKD-5D patients (66 on hemodialysis and 51 on peritoneal dialysis) with a mean age of 62 ± 15 years were studied for a median follow-up period of 68 months. After baseline assessment, including measurement of sMg and MDS, all patients were followed up for cardiovascular (CV) and all-cause mortality. Results: Forty deaths occurred, 58% of which were cardiovascular. Patients who were above the median value of sMg (2.2 mg/dL) had a 66% reduction in CV (crude HR, 0.34; 95% CI, 0.11-0.70), and 49% reduction in all-cause (crude HR, 0.51; 95% CI, 0.27-0.96) mortality, even after adjustment for age, malnutrition inflammation score, left ventricular mass index, peripheral vascular disease and diabetes. Similar results were obtained when sMg was analyzed as a continuous variable. sMg was associated directly with MDS (r = 0.230; p = 0.012). Conclusions: Higher sMg levels are strongly and independently associated with reduced CV and all-cause mortality in CKD-5D patients. A strong correlation exists between MDS and sMg. Elevated sMg levels, achieved through MD adherence, can significantly reduce CV mortality, implicating MD as a mediator of the association between sMg and CV mortality.

Keywords: Mediterranean diet; cardiovascular; hemodialysis; magnesium; mortality; peritoneal dialysis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The correlations between serum Mg (mg/dL) and (A) Mediterranean diet score (MDS) and (B) consumption of recommended foods. Overlapping circles indicate similar values out of 117 patients. Dotted lines indicate 95% C.I. (confidence interval) of the correlation (continuous black line).
Figure 2
Figure 2
Kaplan–Meier survival analysis of (A) cardiovascular and (B) all-cause mortality in patients with serum magnesium (sMg) levels above the median (High Mg) compared with those with levels below the median (low Mg).
See this image and copyright information in PMC

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