Background And Objectives: Circulating levels of anions that bind to magnesium and calcium are often altered in patients with CKD. However, it is unknown how these alterations affect the ionized fraction of magnesium and calcium.
Design, Setting, Participants, & Measurements: This cross-sectional study involved patients on maintenance hemodialysis and patients not on dialysis who visited the outpatient department of nephrology. We collected whole-blood samples to measure ionized magnesium and calcium concentrations. Adjusted anion gap was calculated as an integrative index of unmeasured anions.
Results: A total of 118 patients on hemodialysis and 112 patients not on dialysis were included. Although the prevalence of hypermagnesemia defined by total magnesium was much higher in patients on hemodialysis than in patients not on dialysis (69% versus 12%; <0.001), the prevalence of hypermagnesemia defined by ionized magnesium did not differ significantly (13% versus 18%; =0.28). Among patients on hemodialysis with high total magnesium, 83% had normal or low ionized magnesium. Consequently, the mean ionized fraction of magnesium in patients on hemodialysis was significantly lower than that in patients not on dialysis (51% versus 63%; <0.001). Similarly, the mean ionized fraction of calcium in patients on hemodialysis was lower than that in patients not on dialysis (55% versus 56%; <0.001). In patients on hemodialysis who had a higher adjusted anion gap than patients not on dialysis (mean [SD]: 14.1 [2.2] versus 5.1 [3.1]), the ionized fractions of magnesium and calcium were inversely associated with the adjusted anion gap. Furthermore, the anion gap significantly improved predictions of ionized magnesium and calcium in patients on hemodialysis.
Conclusions: Anions that accumulate in patients on hemodialysis contribute to the lower ionized fraction of magnesium and calcium. Equations that incorporate the anion gap provide better predictions of ionized magnesium and calcium in patients on hemodialysis.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5967434 | PMC |
| http://dx.doi.org/10.2215/CJN.07930717 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of non-English as primary language on clinical outcomes for arteriovenous fistula creation within a safety net system.
Am J Surg
January 2025
Division of Vascular Surgery, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA. Electronic address:
Approximately 22 % of the United States population communicates in a non-English language, potentially impacting healthcare communication and outcomes. Few studies have examined the association between non-English primary language (NEPL) and surgical outcomes and none to our knowledge in patients undergoing arteriovenous fistula creation within a safety net system. In this study, we conducted a retrospective analysis on adults who underwent AVF creation for hemodialysis access between January 1, 2014, and December 31, 2019.
View Article and Find Full Text PDFProgram Director and Nephrology Fellow Perception of Home Hemodialysis Education in the United States.
Kidney360
November 2024
Nephrology Service, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, MD.
Background: Public policy focuses on increasing the prevalence of home dialysis. Home hemodialysis (HHD) education and comfort with the procedure are significant barriers to increasing prevalence. This study examines nephrology fellowship didactic curriculum, training program infrastructure and barriers identified by both program directors and trainees.
View Article and Find Full Text PDFAssociation of blood urea nitrogen with 28-day mortality in critically ill patients: A multi-center retrospective study based on the eICU collaborative research database.
PLoS One
January 2025
Department of Haemodialysis, Fuyong People's Hospital of Baoan District, Shenzhen, Guangdong Province, China.
Objective: Blood urea nitrogen (BUN) is a commonly used biomarker for assessing kidney function and neuroendocrine activity. Previous studies have indicated that elevated BUN levels are associated with increased mortality in various critically ill patient populations. The focus of this study was to investigate the relationship between BUN and 28-day mortality in intensive care patients.
View Article and Find Full Text PDFBackground And Aims: A catheter-related bloodstream infection (CRBSI) is a life-threatening complication of hemodialysis. It is responsible for significant morbidity and mortality and a costly long hospital stay. Despite its burden, little is known about the factors associated with it and the antibiogram of its responsible causative bacteria.
View Article and Find Full Text PDFFatal Delayed Cardiac Tamponade Following Atrial Fibrillation Ablation: A Case Report.
Cureus
December 2024
Internal Medicine, Hurley Medical Center, Flint, USA.
Catheter ablation procedure for symptomatic atrial fibrillation is an established treatment. Cardiac tamponade is one of the several complications associated with atrial fibrillation ablation. We present the case of a 60-year-old male with a past medical history of end-stage renal disease (ESRD) on hemodialysis, hypotension on midodrine, atrial fibrillation status post-ablation a week prior, and a cerebrovascular accident who presented to the emergency department with complaints of weakness, nausea, vomiting, confusion and some syncopal episodes for the past few days.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!