Study On The Relationship Between Serum Magnesium And Abdominal Aortic Calcification In Patients With Chronic Kidney Disease

Background Vascular calcification has a higher incidence in chronic kidney disease,especially after the 3rd stage of chronic kidney disease(CKD).Clinical hazards are closely related to calcification sites.Such as cerebral artery calcification is prone to acute cerebral accident,carotid calcification is prone to cerebral circulation insufficiency,coronary artery calcification is prone to heart failure and myocardial infarction,subcutaneous small vessels calcification can cause skin ulcer and secondary infection,ischemic necrosis may occur in vascular calcification at the end of the extremities,et al.The morbidity of vascular calcification especially coronary artery calcification is as high as90%,as well as a higher mortality.Vascular calcification increased the mortality of patients with CKD.Delaying or preventing calcification is beneficial to improve the outcomes and the survival rate.At present,the pathogenesis of vascular calcification in CKD patients is still not very clear.The effect of serum phosphorus and calcium phosphorus product on vascular calcification were universally recognized.We have achieved expected outcomes through treatment of calcium and phosphorus disorders actively.Nevertheless,the progress of vascular calcification are inevitable although with calcium and phosphorus ideally.We guess that calcium and phosphorus are not the only factors.Further study found that fibroblast growth factor-23(FGF23),klotho,bone morphogenetic protein(BMP),osteoprotegerin(OPG),and matrix gla protein(MGP)played an important role in the occurrence and development of vascular calcification.Researchers have also found that serum magnesium is involved in the pathophysiology f vascular calcification besides its physiological functions.It is of great clinical significance to actively seek for high risk factors of vascular calcification in patients with CKD.Objective To investigate the relationship between magnesium and abdominal aortic calcification(AAC)in patients with CKD,and then speculate the intervention measures of vascular calcification.Methods67 cases with CKD3-5D were enrolled in the 295 inpatients who hospitalized in the Anhui Provincial Hospital of nephrology in 2016 from August1 to October 31.The CKD diagnosis was based on the kidney disease improving global outcomes(KDIGO)and then was staged.Demographic data,clinical data and laboratory data were collected.The diagnosis of AAC was determined by abdominal lateral X-ray plain.Cases were divided into calcification group and non calcification group according to whether AAC was detected.The age,sex,weight,stage of CKD,primary disease,calcium,phosphorus,magnesium,calcium phosphorus product,intact parathyroid hormone(i PTH),25 hydroxyvitamin D,albumin,cholesterol,triglyceride and C reactive protein of two groups were compared,and then analyze the significant difference data for risk factors of AAC in CKD3-5D.Results There are 15 cases with AAC(22.4%),52 cases without AAC(77.6%).Among those,38 were male(56.7%)and 29 were women(43.3%).There was no significant difference in gender(P=0.771),body weight(P=0.630)and CKD staging(P=0.190)between the two groups.The age of calcification group(P < 0.001)and the prevalence ate of hypertension(P=0.016)were higher than those without calcification.The serum calcium concentration(P=0.003),blood phosphorus concentration(P=0.041)and calcium phosphorus product(P < 0.001)were higher than those without calcification in the two groups.The serum magnesium concentration in the calcification group was lower than that in the non calcified group(2.2 ± 0.2 vs 2.4 ± 0.40mg/dl,P=0.006).There were no significant differences between the two groups of serum albumin(P=0.654),i PTH(P=0.891),25 hydroxyvitamin D(P=0.925),cholesterol(P=0.648)and triglyceride(P=0.282).Two classification of Logistic regression analysis showed that age,serum phosphorus and calcium phosphorus product were the independent risk factors of AAC(OR > 1,P < 0.05).Serum magnesium was a protective factor for vascular calcification,(OR=0.072,95%Cl:0.006~0.836 mg/dl,P=0.035).Conclusion Age,high calcium and phosphorus patients prone to AAC,low magnesium is addition to age,serum phosphorus and calcium phosphorus products of the AAC independent risk factor,improving serum magnesium concentration certainly may be conductive to delay the progress of AAC.