Association between serum magnesium levels and cognitive function in patients undergoing hemodialysis.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY Clinical and Experimental Nephrology Pub Date : 2024-11-01 Epub Date: 2024-07-02 DOI:10.1007/s10157-024-02528-0

Kazuhiko Kato, Akio Nakashima, Shunichiro Shinagawa, Arisa Kobayashi, Ichiro Ohkido, Mitsuyoshi Urashima, Takashi Yokoo

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Abstract

Background: The relationship between chronic kidney disease-mineral and bone disorder (CKD-MBD) and cognitive function remains largely unknown. This cross-sectional study aimed to explore the association between CKD-MBD and cognitive function in patients on hemodialysis.

Methods: Hemodialysis patients aged ≥ 65 years without diagnosed dementia were included. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). CKD-MBD markers, serum magnesium, intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OHD), fibroblast growth factor (FGF)-23, and soluble α-klotho were measured.

Results: Overall, 390 patients with a median age of 74 (interquartile range, 70-80) years, mean serum magnesium level of 2.4 ± 0.3 mg/dL, and median MoCA and MMSE scores of 25 (22-26) and 28 (26-29), respectively, were analyzed. MoCA and MMSE scores were significantly higher (preserved cognitive function) in the high-magnesium group than in the low-magnesium group according to the unadjusted linear regression analysis (β coefficient [95% confidence interval (CI)] 1.05 [0.19, 1.92], P = 0.017 for MoCA; 1.2 [0.46, 1.94], P = 0.002 for MMSE) and adjusted multivariate analysis with risk factors for dementia (β coefficient [95% CI] 1.12 [0.22, 2.02], P = 0.015 for MoCA; 0.92 [0.19, 1.65], P = 0.014 for MMSE).

Conclusions: Higher serum magnesium levels might be associated with preserved cognitive function in hemodialysis patients. Conversely, significant associations were not observed between cognitive function and intact PTH, 25-OHD, FGF-23, or soluble α-klotho levels.

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血液透析患者血清镁水平与认知功能之间的关系。

背景：慢性肾脏病-矿物质和骨骼疾病（CKD-MBD）与认知功能之间的关系在很大程度上仍然未知。这项横断面研究旨在探讨血液透析患者中 CKD-MBD 与认知功能之间的关系。认知功能采用蒙特利尔认知评估（MoCA）和迷你精神状态检查（MMSE）进行评估。还测量了慢性肾功能衰竭-MBD 标志物、血清镁、完整甲状旁腺激素（PTH）、25-羟维生素 D（25-OHD）、成纤维细胞生长因子（FGF）-23 和可溶性 α-klotho：共分析了 390 名患者，他们的中位年龄为 74 岁（四分位数间距为 70-80 岁），平均血清镁水平为 2.4 ± 0.3 mg/dL，中位 MoCA 和 MMSE 评分分别为 25 分（22-26 分）和 28 分（26-29 分）。根据未经调整的线性回归分析（β系数[95% 置信区间 (CI)] 1.05 [0.19, 1.92]，MoCA=0.017；MMSE=1.2[0.46, 1.94]，P=0.002），以及与痴呆风险因素的调整多变量分析（β系数[95% CI] 1.12 [0.22, 2.02]，MoCA=0.015；MMSE=0.92 [0.19, 1.65]，P=0.014）：结论：较高的血清镁水平可能与血液透析患者认知功能的保持有关。相反，在认知功能与完整的 PTH、25-OHD、FGF-23 或可溶性 α-klotho 水平之间没有观察到明显的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.