Changes in the serum magnesium in chronic kidney disease patients receiving multiple maintenance haemodialysis over a period of two months – A New Insight

Objective: Magnesium is an important divalent cation with protean functions. Chronic Kidney disease (CKD) is the most common cause for hypermagnesemia. It is possible that CKD patients on Maintenance Haemodialysis (MHD) could have hypermagnesemia due to inadequate clearing of magnesium during dialysis. It is also possible that periodic haemodialysis could result in excess clearing of serum magnesium leading to a progressive hypomagnesemia. Information of the serum magnesium levels in patients with multiple sittings of MHD is not available. This study was undertaken to evaluate the impact of MHD on serum magnesium levels following multiple sittings of MHD. Material and Methods: 44 CKD patients on MHD were enrolled in the study after obtaining informed consent. Pre and Post dialysis samples were assayed for serum magnesium on a fully automated clinical chemistry analyser along with other renal parameters. Results: There was no significant difference between the mean of the pre and post dialysis serum magnesium levels. However, over a period of two months, it was found that there was a gradual decrease in the serum magnesium levels, and this difference was found to be statistically significant. Conclusion: The study shows that there is a mild but progressive decrease in the serum magnesium levels over multiple sittings of MHD. This needs to be monitored and supplemented as hypomagnesemia is associated with increased cardiovascular events in CKD patients.