Yan-Ping Cao,1 Li-Ping Zhu,2 Hai-Jiang Ge,3 Rui-Qing Zhang,1 Ru-Juan Chen,1 Bo Yuan,1 Wei-Jia Shi1 

1Second Department of Nephrology, Handan First Hospital, Handan, Hebei Province, 056002, People’s Republic of China; 2Department of Nephrology, Lianyungang Second Hospital, Lianyungang, Jiangsu Province, 222000, People’s Republic of China; 3First Department of General Surgery, Handan First Hospital, Handan, Hebei Province, 056002, People’s Republic of China

Correspondence: Yan-Ping Cao, Second Department of Nephrology, Handan First Hospital, Handan, Hebei Province, 056002, People’s Republic of China, Tel +86 18631015517, Fax +86 0310-8635761, Email cyp_yanpingcao@126.com

Background: Magnesium is one of the important minerals in the human body. The metabolic imbalance of magnesium has been found in patients with chronic kidney disease (CKD), but the research on the serum magnesium level of patients with non-dialysis-dependent CKD (NDD-CKD) and its relationship with mineral-skeletal metabolic disorder (CKD-MBD) is still relatively limited. This study aims to explore the changes in serum magnesium levels in patients with non-dialysis-dependent CKD at different stages and evaluate its relationship with mineral metabolism markers (calcium, phosphorus, iPTH and alkaline phosphatase).
Methods: A retrospective analysis was conducted on data from 156 patients with stage 3– 5 CKD (G3–G5) admitted to Handan First Hospital between March 2017 and December 2019. Serum magnesium, calcium, phosphorus, intact parathyroid hormone (iPTH), and alkaline phosphatase (AKP) levels were analyzed. The patients were categorized into hypomagnesemia, normal magnesium, and hypermagnesemia groups based on serum magnesium levels. Correlations between magnesium levels and phosphorus, iPTH, and AKP levels were analyzed.
Results: Serum magnesium levels displayed an upward trend across CKD stages G3 to G5, though this trend was not statistically significant. The prevalence of hypomagnesemia was 0%, 6.82%, and 15.07%, while the incidence of hypermagnesemia was 5.13%, 13.64%, and 30.14% in G3, G4, and G5 stages, respectively. Serum magnesium levels demonstrated a significant positive correlation with serum calcium and the calcium-phosphorus product, whereas no correlation was observed with serum phosphorus or iPTH levels.
Conclusion: Magnesium metabolic disorders progressively increase with CKD severity, with the highest prevalence observed in stage G5. These findings indicate that changes in serum magnesium levels may influence the development and progression of CKD-MBDs.

Keywords: non-dialysis-dependent chronic kidney disease, NDD-CKD, mineral metabolism disorders, secondary hyperparathyroidism, magnesium imbalance