Correlation between Postdialysis Serum Magnesium Levels and Atherosclerosis Risk among Chronic Kidney Disease Patients: A Cross-sectional Study

Introduction: Chronic Kidney Disease (CKD) patients undergoing haemodialysis are more prone for hypomagnesemia. A lack of magnesium can hasten the development of atherosclerosis and vascular calcification. The most widely used non invasive marker for assessing atherosclerosis risk is the measurement of Carotid Intima-Media Thickness (CIMT). The role of magnesium in cardiovascular health can be assessed by correlating serum magnesium levels with CIMT. Aim: To correlate postdialysis serum magnesium levels and atherosclerosis risk as measured by ultrasound-guided CIMT in CKD patients undergoing Maintenance Haemodialysis (MHD). Materials and Methods: A hospital-based cross-sectional study was conducted at KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India from May 2023 to July 2023. The study included 100 CKD patients undergoing MHD. Postdialysis, serum magnesium levels and CIMT were measured. Relevant laboratory investigations and clinical history were taken from the case records. Analysis of variance and Student’s t-test were employed for the statistical analysis of the data. The correlation between the parameters was assessed using Pearson’s correlation coefficient. Results: The mean magnesium level was 1.5±0.3 mg/dL, 36% of the study population had hypomagnesemia. The mean right- side and left-side CIMT in the study population were 0.56 mm and 0.6 mm, respectively. There was a negative correlation between CIMT and magnesium (Right CIMT r-value=-0.046, p-value=0.651; Left CIMT r-value=-0.066, p-value=0.512), but it was not statistically significant. CIMT showed a significant negative correlation with serum creatinine (Right CIMT r-value=-0.220, p-value=0.029; Left CIMT r-value=-0.126, p-value=0.216) and serum phosphate (Right CIMT r-value=- 0.256, p-value=0.017; Left CIMT r-value=-0.233, p-value=0.030). CIMT showed a significant correlation between with duration of hypertension (Right CIMT r-value=0.299, p-value=0.003; Left CIMT r-value=0.232, p-value=0.020) and dialysis (Right CIMT r-value=0.288, p=0.004; Left CIMT r-value=0.204, p-value=0.041). Conclusion: There was a negative correlation between CIMT and serum magnesium levels, but it was not statistically significant. Thus, decreased serum magnesium levels may be an additional risk factor, along with disordered homeostasis of calcium, phosphorous, duration of dialysis, diabetes and hypertension, for developing adverse cardiovascular events.