Prevalence of dysmagnesemia among CKD patients in North India

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Shailata Prisi
Kajal Nandi
Elvia Jamatia
Biplob Kumar Biswas
Vatsala Khurana
Binita Goswami


CKD, dysmagnesemia, magnesium level, prevalence


Magnesium is the second-most common intracellular cation after calcium with 99% of total body magnesium distributed intracellularly in bones, muscles, and soft tissues. Only 1% of total body magnesium is present extracellularly that contributes to the normal serum magnesium concentration of 1.8–2.6 mg/dL. Recently, many studies have focused on the role of magnesium homeostasis and human health. Diabetes and hypertension are the leading causes of chronic kidney disease (CKD), and the significance of magnesium in CKD has been astonishing in medical practice. In this study, we investigated the serum levels of magnesium and its prevalence at different stages of CKD. This cross-sectional descriptive study was conducted over a period of 2 months. Serum magnesium levels were analysed in 224 patients with CKD and were grouped into five stages of CKD according to the guidelines of the Kidney Disease: Improving Global Outcomes (KDIGO) based on glomerular filtration rate. Laboratory data of patients was analysed using the IBM SPSS V23 software (Chicago, USA) for statistical relationship between serum magnesium levels and stages of CKD in patients with CKD. Mean serum magnesium level of the study population was 2.21 ± 0.75 mg/dL; 50.9% of the patients were normomagnesemic (normal level of magnesium ions in the blood), followed by 30.4% hypomagnesemic and 20.5%, hypermagnesemic. CKD was more common in males (63.4%), compared to females (36.6%). Mean age of patients in G5 stage was significantly higher than in G3a, G3b, and G4 stages (P = 0.001). A progressive decline in renal function and retention of uraemic solutes was observed with progression of CKD. Multiple factors, both inherited or acquired, such as diuretics and alcohol, are implicated in controlling serum magnesium levels. Magnesium deficiency leads to 2.12-fold higher risk of progression to end-stage renal disease (ESRD).

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1. Romani AMP. Magnesium homeostasis in mammalian cells. Front Biosci J Virtual Libr. 2007;12:308–31. 10.2741/2066

2. Kostov K. Effects of magnesium deficiency on mechanisms of insulin resistance in type 2 diabetes: Focusing on the processes of insulin secretion and signaling. Int J Mol Sci. 2019;20:1351. 10.3390/ijms20061351

3. Severino P, Netti L, Mariani MV, Maraone A, D’Amato A, Scarpati R, et al. Prevention of cardiovascular disease: Screening for magnesium deficiency. Cardiol Res Pract. 2019;2019:4874921. 10.1155/2019/4874921

4. Massy ZA, Drüeke TB. Magnesium and cardiovascular complications of chronic kidney disease. Nat Rev Nephrol. 2015;11:432. 10.1038/nrneph.2015.74

5. Nielsen FH. Magnesium deficiency and increased inflammation: Current perspectives. J Inflamm Res. 2018;11:25–34. 10.2147/JIR.S136742

6. Schindler EI, Brown SM, Scott MG. Electrolytes and blood gases. In: Teitz fundamentals of clinical chemistry 6th ed, Chap. 35.

7. Felsenfeld AJ, Levine BS, Rodriguez M. Pathophysiology of calcium, phosphorus, and magnesium dysregulation in chronic kidney disease. Semin Dial. 2015 Nov;28(6):564–77. 10.1111/sdi.12411

8. Kidney International. Definition and classification of chronic kidney disease: A position statement from kidney disease: Improving global outcomes (KDIGO) [Internet]. [cited 2022 Mar 27]. Available from:

9. Navarro-González JF, Mora-Fernández C, García-Pérez J. Clinical implications of disordered magnesium homeostasis in chronic renal failure and dialysis. Semin Dial. 2009;22:37–44. 10.1111/j.1525-139X.2008.00530.x

10. Martin KJ, González EA, Gellens ME, Hamm LL, Abboud H, Lindberg J. Therapy of secondary hyperparathyroidism with 19-nor-1alpha,25-dihydroxyvitamin D2. Am J Kidney Dis. 1998;32(2 Suppl 2):S61–6. 10.1053/ajkd.1998.v32.pm9808145

11. Kotha NB, Ganesh M, Manikandan A, Selvarajan S, Muthukathan R. Serum magnesium levels in chronic kidney disease patients. Sri Ramachandra J Health Sci (SRJHS). 2022 Jul 15;2(1):29–32.

12. Oka T, Hamano T, Sakaguchi Y, Yamaguchi S, Kubota K, Senda M, et al. Proteinuria-associated renal magnesium wasting leads to hypomagnesemia: A common electrolyte abnormality in chronic kidney disease. Nephrol Dial Transplant. 2019;34:1154–62. 10.1093/ndt/gfy119

13. Sakaguchi Y, Hamano T, Kubota K, Oka T, Yamaguchi S, Matsumoto A, et al. Anion gap as a determinant of ionized fraction of divalent cations in hemodialysis patients. Clin J Am Soc Nephrol (CJASN). 2018 Feb 7;13(2):274–81. 10.2215/CJN.07930717

14. Sakaguchi Y. The emerging role of magnesium in CKD. Clin Exp Nephrol. 2022 Jan;26(5):379–384. 10.1007/s10157-022-02182-4

15. Takayanagi K, Shimizu T, Tayama Y, Ikari A, Anzai N, Iwashita T, et al. Downregulation of transient receptor potential M6 channels as a cause of hypermagnesiuric hypomagnesemia in obese type 2 diabetic rats. Am J Physiol Renal Physiol. 2015 Jun 15;308(12):F1386–97. 10.1152/ajprenal.00593.2013

16. Turgut F, Kanbay M, Metin MR, Uz E, Akcay A, Covic A. Magnesium supplementation helps to improve carotid intima media thickness in patients on hemodialysis. Int Urol Nephrol. 2008 Dec;40(4):1075–82. 10.1007/s11255-008-9410-3

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