The Relationship Between Serum Phosphorus And Serum Magnesium And Calcification In Patients With CKD

Objective(s): To analyze the effects of blood phosphorus and serum magnesium on vascular calcification in patients with chronic kidney disease(CKD).Methods: 447 patients with stage CKD1-5D admitted to the Department of Nephrology,The Sixth Affiliated Hospital of Kunming Medical University(Yuxi People’s Hospital)from November 2021 to December 2022 were selected as study objects.Clinical data and laboratory indicators of the patients were collected,and abdominal aortic calcification scores were performed by lateral abdominal X-ray.The patients were divided into calcification group and non-calcification group according to the abdominal aorta calcification scoring criteria.According to the blood phosphorus level,the patients were divided into low phosphorus group(blood phosphorus <0.85mmol/L),normal phosphorus group(0.85mmol/L≤ blood phosphorus ≤1.51mmol/L)and high phosphorus group(blood phosphorus >1.51mmol/L)according to the laboratory blood phosphorus reference interval.Then,under the blood phosphorus concentration of each group,according to the blood magnesium level,according to the laboratory magnesium reference interval,namely low magnesium(blood magnesium <0.75mmol/L),normal magnesium(0.75mmol/L≤ blood magnesium ≤1.02mmol/L),high magnesium(blood magnesium >1.02mmol/L),They were divided into low phosphorus-low magnesium group,low phosphorus-normal magnesium group,low phosphorus-high magnesium group and normal phosphorus-low magnesium group,normal phosphorus-normal magnesium group,normal phosphorus-high magnesium group.To analyze and compare whether there were differences in vascular calcification among magnesium concentrations in different phosphorus groups,the effects of diabetes,hypertension,serum albumin,triglyceride,total cholesterol,blood phosphorus,magnesium,calcium and other factors on vascular calcification in patients with CKD were analyzed by single Logistic regression.Multivariate Logistic regression was used to analyze the influence of various factors on vascular calcification in patients with CKD..Results: Among the enrolled cases,137 cases(30.65%)had abdominal aortic calcification.Compared with the non-calcified group,age(P<0.001),blood phosphorus(P=0.046),C-reactive protein(P=0.019),i PTH(P=0.010),incidence of diabetes(P<0.001),incidence of hypertension(P<0.001)in calcification group were higher than those in non-calcification group.Blood magnesium(P=0.007)and e GFR(P=0.026)were lower than those in non-calcification group,but there was no significant difference in gender,vitamin D and its analogues consumption history,calcium-phosphorus product,triglyceride and total cholesterol between the two groups(P>0.05).There was no significant difference in blood magnesium level between the groups with normal blood phosphorus(P>0.05).With high blood phosphorus,there were statistically significant differences among the groups with different blood magnesium levels(P=0.001),and in the high phosphorus group,the incidence of vascular calcification decreased from 83.33% in the high phosphorus--low magnesium group to 13.33% in the high phosphorus--high magnesium group.Univariate Logistic regression shows: Age,diabetes mellitus,hypertension,smoking,e GFR,corrected calcium,blood phosphorus,blood magnesium and total cholesterol may affect vascular calcification in stage CKD1-5D patients to some extent(all P<0.05).All variables with P<0.05,gender,history of vitamin D and its analogues,fasting blood glucose,albumin,i PTH,triglyceride and C-reactive protein were included in multivariate Logistic regression(progressive logistic regression),and it was found that hypertension,blood phosphorus and age were independent risk factors for vascular calcification in CKD patients with OR values were(OR= 2.984,95%CI1.419-6.227),(OR= 1.109,95%CI 1.043-1.179),(OR=1.071,95%CI 1.048-1.093).Blood magnesium was an independent protective factor for vascular calcification(OR=0.713,95%CI0.591-0.861).Conclusions: 1.Hypo-magnesium is an independent risk factor for vascular calcification in patients with CKD,and an increase in magnesium concentration within a certain range may delay or inhibit the progression of vascular calcification;2.High blood phosphorus is an independent risk factor for vascular calcification,and when high blood phosphorus is present,the incidence of vascular calcification gradually decreases with the increase of blood magnesium concentration,which may slow down or inhibit the vascular calcification caused by high phosphorus.3.Hypertension and old age are independent risk factors for vascular calcification in patients with CKD.