Research On Relationship Between Serum Magnesium And Nutritional Index And Mortality Of Peritoneal Diaiysis Patients

Objective : Previous studies have reported that serum magnesium abnormality has association with general population,chronic kidney disease and hemodialysis patients in increased mortality.However,it is unclear whether serum magnesium level disorders have association with peritoneal dialysis.The purpose of the study was to evaluate the association between serum magnesium disorder and mortality and cardiovascular mortality in peritoneal dialysis patients,and searched for risk factors influencing serum magnesium.Method:This is a single center retrospective study,this study included peritoneal dialysis patients from January 1,2010 and June 30,2017 and followed to December 31,2017 in the Third Hospital of Hebei Medical University.Demographic,clinical and laboratory indicators of the patients were collected.The primary end point was all cause mortality and cardiovascular mortality of peritoneal dialysis patients.Hypermagnesemia was defined as serum magnesium level greater than 1.02mmol/L,hypomagnesemia was defined as serum magnesium level lower than 0.75mmol/L.Result:There were 204 peritoneal dialysis patients including in our study,53.4% of them were male,46.6% were female.The primary incidence of diabetic nephropathy was 27.4%.The average age of patients starting peritoneal dialysis were(49.4 ± 15.3)years and the median duration of peritoneal dialysis were 32 months.Among them,65 patients(31.8%)had hypermagnesemia,only 4 patients(2%)had hypomagnesemia.After 90 months following up,26 patients(12.7%)died and 11 patients(42.3%)died of cardiovascular events.Serum magnesium levels had a negative association with age(r=-0.158,P=0.024),and had a positive association with serum albumin(r=0.258,P=0.000),serum phosphorus(r=0.251,P=0.000),serumcreatinine(r=0.223,P=0.001).According to Logistics regression analysis,serum albumin(P=0.000)?serum phosphorus(P=0.048)?serum creatinine level(P=0.008)were the independent influencing factors affecting serum magnesium level in patients with peritoneal dialysis.There was no significant difference in all cause mortality(P=0.251)and cardiovascular mortality(P=0.693)between serum magnesium normal group and hypermagnesemia group.In the multivariate Cox regression analysis,hyperphosphatemia(HR=0.350,P=0.021),high parathyroid hormone level(HR=2.822,P=0.001),the history of diabetes(HR=7.651,P=0.000)were predictors of all cause mortality in peritoneal dialysis patients.The history of diabetes(HR=16.595,P=0.000)was a major predictor of cardiovascular mortality in peritoneal dialysis patients.Conclusion:1.The incidence of hypomagnesemia is low in our peritoneal dialysis center.2.Serum albumin ? serum phosphorus ? serum creatinine level were independent factors affecting serum magnesium level in patients with peritoneal dialysis.3.Serum magnesium had no effect on mortality of peritoneal dialysis patients.4.Hyperphosphatemia,high parathyroid hormone level,the history of diabetes had association with all cause mortality and the history of diabetes had association with cardiovascular mortality in peritoneal dialysis patients indepentently.