Korean Journal of Nephrology 2000;19(6):1071-1077.
혈액투석 환자에서 혈청 마그네슘과 부갑상선호르몬 치의 관계 (Relationship Between Serum Magnesium and Parathyroid Hormone Levels in Hemodialysis Patients)
마성권(Sung Gwon Ma) , 김정기(Jung Gee Kim) , 박미정(Mi Jung Park) , 박병석(Byung Suk Park) , 나명윤(Myung Yoon Na) , 염충호(Choong Ho Yeom) , 김수완(Soo Wan Kim) , 김남호(Nam Ho Kim) , 강영준 , 최기철(Gee Chul Choi)
Abstract
The important factors involved in the regulation of PTH are calcium, vitamin D, and phosphorus. However, recent studies have suggested that magnesium may also play a significant role in the modulation of PTH. The aims of this study was to analyze the relationship between serum magnesium and PTH levels in the hemodialysis patients. We studied 66 stable patients under maintenance hemodialysis for more than 6 months. Calcium carbonate was used as a phosphate binder in all patients. No patient had been previously treated with vitamin D and aluminum hydroxide. Biochemical parameters were evaluated 3 times during 7 months, and the mean values were computed. The mean serum magnesium level was 2.7±0.4 mEq/L. Hypermagnesemia(defined as serum Mg>2.2 mEq/L) was found in 60 patients(90.1%). Serum magnesiurn levels were inversely correlated with senum iPTH levels(r=-0.579; p<0.001). Serum total and ionized calcium levels were inversely correlated with serum iPTH levels(r=-0.743; p<0.001, r=-0.699; p<0.001, respectively). Serum alkaline phosphatase levels positively correlated with serum iPTH levels (r=0.364; p=0.003). In lower iPTH group(serum iPTH120pg/mL), serum magnesium, total calcium, and ionized calcium levels were significantly higher. Alkaline phosphatase level was significantly lower in lower PTH group. After controlling for the effect of the other variables, serum magnesium and iPTH levels were inversely correlated(r=-0.53; p<0.001). A stepwise multiple regression analysis showed that serum magnesium level was the most predictive variable(R²=0.72; p<0.001). Hypermagnesemia is frequent in hemodialysis patients. There is a significant inverse relationship between serum magnesium and PTH levels. In addition, serum magnesium concentration has an important influence on PTH regulation. These results suggest that hypermagnesemia may have a suppressive effect on PTH regulation in hemodialysis patients.
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