Publications (2)0 Total impact
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Article: Relationship of serum magnesium to body composition and inflammation in peritoneal dialysis patients.
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ABSTRACT: Magnesium is one of the most abundant cations in the body and is involved in many cell functions. Serum magnesium concentration is maintained within a narrow range by the kidney and digestive tract. It has been reported that a lower serum magnesium level is a significant predictor for mortality in hemodialysis patients. Body composition and inflammation are important predictors of mortality in peritoneal dialysis (PD) patients. The objective of the present study was to examine the relationship of serum magnesium with body composition and inflammation in PD patients. Our study enrolled 62 PD patients treated at the Long Island College Hospital between November 2000 and July 2008. Demographic, clinical, and biochemical data were recorded. Body composition parameters were determined by bioelectrical impedance analysis (BIA). High sensitivity C-reactive protein (hs-CRP), a marker of inflammation was measured by the immunoturbidimetric method. In these patients (mean age: 55 years; 63% African American; 55% women; 25% with diabetes), the mean (+/- standard deviation) serum magnesium and hs-CRP were 1.597 +/- 0.28 mEq/L and 13.70 +/- 21 mg/L respectively. Serum magnesium was directly correlated with serum markers of nutrition: albumin (r = 0.42, p = 0.001), creatinine (r = 0.43, p = 0.0001), and total protein (r = 0.44, p < 0.0001). Serum magnesium was also directly correlated with phase angle, a BIA parameter and marker of cellular health (correlation coefficient: r = 0.35; p = 0.006), and inversely correlated with the extracellular mass/body cell mass ratio (r = -0.34, p = 0.008), a highly sensitive marker of malnutrition. We observed an inverse correlation between serum magnesium and hs-CRP (r = -0.37, p = 0.02) in PD patients. In conclusion, lower serum magnesium is associated with poorer nutrition status, deteriorating cellular health, and increased inflammation, which may contribute to the increased risk of mortality in PD patients.Advances in peritoneal dialysis. Conference on Peritoneal Dialysis 01/2010; 26:112-5. -
Article: Enrollment fluid status is independently associated with long-term survival of peritoneal dialysis patients.
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ABSTRACT: Fluid overload is a common complication in peritoneal dialysis (PD) patients. The prognostic importance of enrollment fluid status in long-term PD patients remains to be investigated. The objective of the present study was to investigate the prognostic importance of enrollment fluid status in the long-term survival of PD patients. We enrolled 53 PD patients (mean age: 53 years) from November 2000 to February 2006. On enrollment, demographic, clinical, and biochemical data were recorded. Bioelectrical impedance analysis (BIA) was used to determine the fluid status of PD patients, including extracellular water (ECW), intracellular water (ICW), and total body water (TBW). Fluid status was corrected for body surface area (BSA): ECW-BSA, ICW-BSA, and TBW-BSA respectively. Patients were followed to January 2008. The ECW-BSA correlated negatively with albumin, a marker of nutrition (r = -0.53, p < 0.0001). The ICW/ECW ratio (r = 0.36, p = 0.018) correlated directly and the ECW/ TBW ratio (r = -0.36, p = 0.019) correlated negatively with creatinine. Patients who survived during the study period had a significantly lower ECW-BSA (8.29 L/m2 vs. 9.91 L/m2, p = 0.001) than did those who did not survive. Patients with enrollment ECW-BSA below 9 L/m2 had a significantly better 7-year cumulative survival (Kaplan-Meier) than did patients with a ECW-BSA of 9 L/m2 or more (p = 0.019). Using multivariate Cox regression analysis, adjusting for age, race, diabetes, human immunodeficiency virus (HIV) status, and months on dialysis at enrollment, ECW-BSA was a significant independent predictor of mortality (relative risk: 1.50; p = 0.03). In conclusion, ECW-BSA was a significant independent predictor of long-term survival in PD patients.Advances in peritoneal dialysis. Conference on Peritoneal Dialysis 02/2008; 24:79-83.
