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Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial

INTRODUCTION: Chronic kidney disease (CKD) is associated with high cardiovascular morbidity and mortality. Recent evidence suggests that increases in both serum and intracellular magnesium (Mg) can slow or even prevent the development of vascular calcification seen in CKD. Serum calcification propen...

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Autores principales: Bressendorff, Iain, Hansen, Ditte, Schou, Morten, Silver, Burton, Pasch, Andreas, Bouchelouche, Pierre, Pedersen, Lise, Rasmussen, Lars Melholt, Brandi, Lisbet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678662/
https://www.ncbi.nlm.nih.gov/pubmed/29142966
http://dx.doi.org/10.1016/j.ekir.2016.12.008
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author Bressendorff, Iain
Hansen, Ditte
Schou, Morten
Silver, Burton
Pasch, Andreas
Bouchelouche, Pierre
Pedersen, Lise
Rasmussen, Lars Melholt
Brandi, Lisbet
author_facet Bressendorff, Iain
Hansen, Ditte
Schou, Morten
Silver, Burton
Pasch, Andreas
Bouchelouche, Pierre
Pedersen, Lise
Rasmussen, Lars Melholt
Brandi, Lisbet
author_sort Bressendorff, Iain
collection PubMed
description INTRODUCTION: Chronic kidney disease (CKD) is associated with high cardiovascular morbidity and mortality. Recent evidence suggests that increases in both serum and intracellular magnesium (Mg) can slow or even prevent the development of vascular calcification seen in CKD. Serum calcification propensity (T(50)) is a novel functional test, which is associated with all-cause mortality in CKD and measures the ability of serum to delay the formation of crystalline nanoparticles. Theoretically, increasing serum Mg should improve T(50) and thereby reduce the propensity towards ectopic calcification. METHODS: We conducted a randomized placebo-controlled double-blinded clinical trial to investigate the safety of 2 different doses of oral Mg supplementation in subjects with CKD stages 3 and 4 as well as their effects on intracellular Mg and T(50). Thirty-six subjects with CKD stages 3 and 4 were randomized to one of 3 groups (placebo, elemental Mg 15 mmol/d or elemental Mg 30 mmol/d) given as slow-release Mg hydroxide and followed for 8 weeks. RESULTS: Thirty-four subjects completed the trial. Intracellular Mg remained stable throughout the trial despite significant increases in both serum and urine Mg. T(50) increased significantly by 40 min from 256 ± 60 (mean ± SD) to 296 ± 64 minutes (95% confidence interval, 11–70, P < 0.05) in the Mg 30 mmol/d group after 8 weeks. No serious adverse events related to the study medication were reported during the study. DISCUSSION: Oral Mg supplementation was safe and well tolerated in CKD stages 3 and 4 and improved T(50), but did not increase intracellular Mg. Further studies are needed to investigate the long-term effects of Mg supplementation in CKD stage 3 and 4 and whether improvement in calcification propensity is related to clinical endpoints.
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spelling pubmed-56786622017-11-15 Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial Bressendorff, Iain Hansen, Ditte Schou, Morten Silver, Burton Pasch, Andreas Bouchelouche, Pierre Pedersen, Lise Rasmussen, Lars Melholt Brandi, Lisbet Kidney Int Rep Clinical Research INTRODUCTION: Chronic kidney disease (CKD) is associated with high cardiovascular morbidity and mortality. Recent evidence suggests that increases in both serum and intracellular magnesium (Mg) can slow or even prevent the development of vascular calcification seen in CKD. Serum calcification propensity (T(50)) is a novel functional test, which is associated with all-cause mortality in CKD and measures the ability of serum to delay the formation of crystalline nanoparticles. Theoretically, increasing serum Mg should improve T(50) and thereby reduce the propensity towards ectopic calcification. METHODS: We conducted a randomized placebo-controlled double-blinded clinical trial to investigate the safety of 2 different doses of oral Mg supplementation in subjects with CKD stages 3 and 4 as well as their effects on intracellular Mg and T(50). Thirty-six subjects with CKD stages 3 and 4 were randomized to one of 3 groups (placebo, elemental Mg 15 mmol/d or elemental Mg 30 mmol/d) given as slow-release Mg hydroxide and followed for 8 weeks. RESULTS: Thirty-four subjects completed the trial. Intracellular Mg remained stable throughout the trial despite significant increases in both serum and urine Mg. T(50) increased significantly by 40 min from 256 ± 60 (mean ± SD) to 296 ± 64 minutes (95% confidence interval, 11–70, P < 0.05) in the Mg 30 mmol/d group after 8 weeks. No serious adverse events related to the study medication were reported during the study. DISCUSSION: Oral Mg supplementation was safe and well tolerated in CKD stages 3 and 4 and improved T(50), but did not increase intracellular Mg. Further studies are needed to investigate the long-term effects of Mg supplementation in CKD stage 3 and 4 and whether improvement in calcification propensity is related to clinical endpoints. Elsevier 2016-12-30 /pmc/articles/PMC5678662/ /pubmed/29142966 http://dx.doi.org/10.1016/j.ekir.2016.12.008 Text en © 2016 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Research
Bressendorff, Iain
Hansen, Ditte
Schou, Morten
Silver, Burton
Pasch, Andreas
Bouchelouche, Pierre
Pedersen, Lise
Rasmussen, Lars Melholt
Brandi, Lisbet
Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial
title Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial
title_full Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial
title_fullStr Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial
title_full_unstemmed Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial
title_short Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial
title_sort oral magnesium supplementation in chronic kidney disease stages 3 and 4: efficacy, safety, and effect on serum calcification propensity—a prospective randomized double-blinded placebo-controlled clinical trial
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678662/
https://www.ncbi.nlm.nih.gov/pubmed/29142966
http://dx.doi.org/10.1016/j.ekir.2016.12.008
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