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Hypomagnesemia after renal transplantation, alert for new on

  Twenty-four percent of renal transplant recipients (KTR) developed new-onset diabetes (NODAT) within 3 years of transplantation. In patients with NODAT or pre-transplant diabetes, poor long-term graft function, failure to transplant, increased risk of cardiovascular disease and mortality after transplantation, compared with non-diabetic KTR, NODAT or pre-transplant diabetes mellitus.

  Risk factors for NODAT were age, ethnicity, family history of diabetes, acute rejection, cytomegalovirus infection, hepatitis C, hormone drugs, and magnesium deficiency. Hypomagnesemia (hypoMg) is a common complication of calcineurin inhibitor (CNI) KTR patients. Studies have reported that CNI can reduce tubular magnesium transporter, resulting in increased magnesium excretion. In this case,

  Several studies have reported a correlation between postmortem hypomagnesemia and NODAT risk, but the results are controversial. Dr. Johnny W. Huang and colleagues from the University of Toronto, and colleagues from the University of Toronto, and colleagues from January 2000 to December 2011 948 cases of non-diabetic KTR Patients were retrospectively cohorted. The results were published in the journal JASN.

  Multivariate Cox proportional hazards models were used to assess the association between NODAT risk and baseline serum magnesium levels (1 month), time (every 3 months), and moving average after adjustment for potential confounders. The incidence of NODAT events during the follow-up period was 182 / 2951.2 person-years. Multivariable model analysis showed a negative correlation between baseline serum magnesium levels and NODAT (hazard ratio [HR] 1.24 / 0.1 mmol / L; 95% confidence interval [95% CI] 1.05-1.46; P = 0.01). 95% CI 1.13-1.57; P = 0.001) for the time-course change model (HR 1.32; 95% CI 1.14-1.52; P <0.001). 95% CI 1.29-2.45; P <0.001) and the mean (HR 1.83; 95% CI 1.07-2.34; P = .05) time-course change (HR 1.78; 95% CI 1.29-2.45; ; P = 0.001) showed a significant association between hypomagnesemia (serum magnesium <0.74 mmol / L) and increased NODAT risk.

  The results show that low serum magnesium levels after transplantation are independent risk factors for NODAT in renal transplant recipients. Appropriate interventions should be taken to prevent or correct hypomagnesemia, thereby reducing the risk of NODAT.

  Source: Hypomagnesemia and the Risk of New-Onset Diabetes Mellitus after Kidney Transplantation. J Am Soc Nephrol. 2016 Jun; 27 (6): 1793-800.

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