Effects Of Serum Magnesium Level On Abnormal Bone Metabolism In Patients With Non-dialysis Chronic Kidney Disease

Objective: To investigate the effects of serum magnesium level on abnormal bone metabolism in patients with non-dialysis chronic kidney disease.Methods: Clinical data of 810 non-dialysis CKD patients in our hospital were retrospectively analyzed.Firstly,five groups were divided according to e GFR: CKD1,CKD2,CKD3,CKD 4 and CKD 5.The clinical data of each group were analyzed statistically.Secondly,the patients were divided into 5 groups according to the normal reference range of serum magnesium 1.8 to 2.4 mg / d L and added graduately by 0.2mg/d L each group in the reference range,respectively: 1: <0.75mmol/L(1.8mg/d L),2: 0.75-<0.83mmol/L(2.0mg/d L),3: 0.83-<0.91mmol/L(2.2mg/d L),4: 0.91-<1mmol/L(2.4mg/d L),5: ?1mg/d L.The clinical data of each group were analyzed statistically.The correlation between serum magnesium and clinical data was analyzed using Spearman correlation test in CKD1-5 and subgroups of CKD5 patients.Through spiral CT,patients were divided into arterial calcification and non-arterial calcification according to whether they have arterial calcification and coronary artery calcification or not.The clinical data of each group were analyzed statistically.The independent risk factors of arterial calcification were analyzed using multivariate logistic regression analysis.Results: The comparison of CKD1-5 patients,it was found that with the progress of CKD,especially CKD5 period had lower hemoglobin,serum albumin,serum calcium,higher urea nitrogen,creatinine,uric acid,serum phosphorus,i PTH.Serum magnesium level was gradually increased with the progress of CKD,especially in patients with CKD5 period serum magnesium levels were significantly increased,there was a statistical difference(P<0.05).Patients in the high serum magnesium group(group 5)had higher lever of serum creatinine,urea nitrogen,uric acid,serum phosphorus,i PTH,lower hemoglobin and e GFR.Lower albumin and higher calcification rate were found in the low serum magnesium group(group 1).Further analysis of Spearman correlation showed that serum magnesium was positively correlated with serum albumin,urea nitrogen,creatinine,serum phosphorus and i PTH and negatively correlated with hemoglobin,ALP,e GFR and calcification in CKD1-5 patients,while serum magnesium was positively correlated with serum albumin,urea nitrogen,creatinine,corrected calcium and serum phosphorus,and negatively correlated with ALP,e GFR and calcification in patients with subgroup CKD5.The clinical data in arterial calcification group and non-arterial calcification group were compared,it was found that age,BMI,diabetes,hypertension,hemoglobin,total cholesterol,triglyceride,LDL-C,serum magnesium,e GFR had statistical difference(P <0.05).Multivariate logistic regression analysis showed that age(OR = 1.125),hypertension(OR = 1.934),anemia(OR = 2.385)and hypomagnesemia(OR = 2.560)were independent risk factors for arterial calcification.Conclusion: There was a certain correlation between serum magnesium and serum calcium,serum phosphorus and i PTH in patients with non-dialysis chronic kidney disease,and serum magnesium level was gradually increased with the progress of CKD.Hypomagnesemia was an independent risk factor for arterial calcification.