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Perit Dial Int 26(3): 366-373 2006
© 2006 International Society for Peritoneal Dialysis
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Clinical

RELATIONSHIP BETWEEN SERUM MAGNESIUM, PARATHYROID HORMONE, AND VASCULAR CALCIFICATION IN PATIENTS ON DIALYSIS: A LITERATURE REVIEW

Mingxin Wei1,2, Khaled Esbaei1,3, Joanne Bargman1 and Dimitrios G. Oreopoulos1

Home Peritoneal Dialysis Unit,1 University Health Network and University of Toronto, Toronto, Ontario, Canada; Department of Nephrology,2 Guangxi People's Hospital, Guangxi, P. R. China; Al-Fatah University,3 Tripoli Central Hospital, Tripoli, Libya

Correspondence to: D.G. Oreopoulos, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8 Canada.dgo{at}teleglobal.ca

Secondary hyperparathyroidism is present in most patients with end-stage renal disease and has been linked to uremic bone disease, vascular calcification, and mortality. Current literature suggests an association between hypomagnesemia and cardiovascular disease in the general population. We reviewed all published studies on the relationship between serum magnesium and parathyroid hormone and the relationship between serum Mg and vascular calcification in dialysis patients. Of these, 10 of 12 studies of patients on hemodialysis and 4 of 5 studies of patients on peritoneal dialysis showed a significant inverse relationship between serum Mg and serum intact parathyroid hormone. Hyperparathyroidism develops in peritoneal dialysis patients dialyzed with a solution containing normal calcium (1.25 mmol/L) and low Mg (0.25 mmol/L), even though serum calcium is maintained at a normal level. Four of the hemodialysis studies and one of the peritoneal dialysis studies indicated that there is an inverse relationship between serum Mg and vascular calcification in these patients. Potential benefits have been attributed to magnesium carbonate as a phosphate binder and it may possibly be an effective, less toxic, less expensive phosphate binder. We believe that the role of Mg in secondary hyperparathyroidism and vascular calcification merits further investigation.

KEY WORDS: Magnesium; parathyroid hormone; vascular calcification; phosphate control.

Received 13 June 2005; accepted 3 October 2005.






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