Effect of magnesium on vascular calcification in chronic kidney disease patients: a systematic review and meta-analysis

Figures & data

Figure 1. Flow diagram of study selection.

Table 1. Baseline characteristic of included studies.

Author, year	Country	Population	Sample size	Duration of HD		Intervention	Control	FU	Outcomes	Design	Jade/ Minors
				Intervention	Control
Turgut et al. 2008[34]	Turkey	HD	44	41.3 ± 28.8^a (months)	19.5 ± 9.2 (months)	610 mg Mg citrate, every other day	Ca acetate	2 months	cIMT, Ca, P, iPTH	RCT	3
Mortazavi et al. 2013[35]	Iran	HD	52	4.53 ± 3.06^a (years)	4.52 ± 2.55 (years)	440 mg Mg oxide, three times a week	Placebo	6 months	cIMT, Ca, P, iPTH	RCT	6
Tzanakis et al. 2014[24]	Greece	HD	59	40 ± 49^a (months)	37 ± 56 (months)	OsvaRen (435 mg Ca acetate combined with 235 mg Mg carbonate per tablet), three tablets daily	600 mg Ca acetate, three tablets daily	12 months	Number of patients with improved VCS, Ca, P, iPTH	RCT	5
Bressendorff et al. 2016[36]	Denmark	CKD 3–4 stage	34	/	/	Slow-release Mg hydroxide 360 mg once daily and twice daily	Placebo once daily	8 weeks	T50, ionCa, P, iPTH	RCT	5
Bressendorff et al. 2018[26]	Denmark	HD	57	39 (21–99)^b (months)	30 (13–59) (months)	High dialysate Mg (2.0 mEq/L)	Standard dialysate Mg (1.0 mEq/L)	42 days	T50, ionCa, P, iPTH	RCT	7
Sakaguchi et al. 2019 [14]	Japan	CKD 3–4 stage	96	/	/	330mg Mg oxide per day	Standard therapy for CKD	2 years	CACS, Ca, P, iPTH	RCT	4
Talari et al. 2019 [37]	Iran	HD	54	4.0 ± 1.0^b (years)	3.8 ± 1.0 (years)	250 mg/d Mg supplements as Mg oxide	Placebo	24 weeks	cIMT	RCT	5
Srisuwarn et al. 2022 [15]	Thailand	HD	40	80（44–105)^b (months)	83（38-128） (months)	High dialysate Mg (1.75 mEq/L)	Standard dialysate Mg (0.7 mEq/L)	26 weeks	CACS, Ca, P, iPTH	Non-RCT	21
Milicevic et al. 2022 [16]	Serbia	HD	60	28.97 ± 14.63^b (months)	23.00 ± 14.66 (months)	Dialysate-Mg level (1 mmol/L)	Dialysate-Mg level (0.5 mmol/L)	12 months	CACS, Ca, P, PTH	RCT	2

FU: follow-up; HD: hemodialysis; CKD: chronic kidney disease; Mg: magnesium; Ca: calcium; P: phosphorus; iPTH: intact parathyroid hormone; ionCa: ionized calcium; cIMT: carotid intima-media thickness; CACS: coronary artery calcium score; VCS: vascular calcification score; T50: serum calcification propensity; RCT: randomized controlled study.

^aMean ± standard deviation; ^bMedians and interquartile ranges.

Figure 2. Effect of magnesium supplementation on serum magnesium level.

Figure 3. Effect of magnesium supplementation on vascular calcification scores.

Figure 4. Effect of magnesium supplementation on T50. T50, serum calcification propensity.

Figure 5. Effect of magnesium supplementation on serum Ca (A) and ionized Ca (B) levels. Ca, calcium.

Figure 6. Subgroup analysis of magnesium supplementation on Ca level. Ca, calcium.

Figure 7. Subgroup analysis of magnesium supplementation on serum P. P, phosphorus.

Figure 8. Magnesium supplementation on PTH level. PTH, parathyroid hormone.

Figure 9. Subgroup analysis of magnesium supplementation on PTH level. PTH, parathyroid hormone.

Figure 10. Magnesium supplementation on left (A) and right (B) cIMT. cIMT, carotid intima-media thickness.

Figure 11. Publication bias assessment. A: Funnel diagram; B: Egger ' s test.

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Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.