Saudi Journal of Kidney Diseases and Transplantation

ORIGINAL ARTICLE
Year
: 2009  |  Volume : 20  |  Issue : 5  |  Page : 766--769

Relation of magnesium level to cyclosporine and metabolic complications in renal transplant recipients


Farrokhlagha Ahmadi, Rozita Naseri, Mahbob Lessan-Pezeshki 
 Department of Nephrology, Tehran University of Medical Sciences, Imam Khomeni Medical Center Keshavarz Blvd, Tehran, Iran

Correspondence Address:
Farrokhlagha Ahmadi
Department of Nephrology, Tehran University of Medical Sciences, Imam Khomeni Medical Center Keshavarz Blvd, Tehran
Iran

Abstract

Cyclosporine is the main immunosuppressive drug used for renal transplant reci計ients in order to prevent transplant rejection. Although the drug has increased the survival of patients and grafted organ, it has some side effects independent of its effect on the immune system. This study was done to evaluate the effect of cyclosporine on serum Mg level and its metabolic side effects in renal allograft patients. 157 (62 female and 95 male) renal transplant recipients treated with cyclosporine to prevent transplant rejection were included in the study. Clinical and biochemical data along with cyclosporine levels was documented. Mean serum Mg level was 196 ± 0.31 mg/dL and mean serum cyclosporine level was 371 ± 192 µg/dL. Hypomagnesemia was detected in 16 (10.2%) with a negative significant correlation with cyclosporine levels, serum creatinine, plasma LDL, fasting Blood sugar and uric acid. In conclusion according to the results of this study there is a significant correlation between cyclosporine and hypomagnesemia. Therefore, routine measurement of serum Mg and its treatment seems necessary to prevent its complications.



How to cite this article:
Ahmadi F, Naseri R, Lessan-Pezeshki M. Relation of magnesium level to cyclosporine and metabolic complications in renal transplant recipients.Saudi J Kidney Dis Transpl 2009;20:766-769


How to cite this URL:
Ahmadi F, Naseri R, Lessan-Pezeshki M. Relation of magnesium level to cyclosporine and metabolic complications in renal transplant recipients. Saudi J Kidney Dis Transpl [serial online] 2009 [cited 2020 Dec 1 ];20:766-769
Available from: https://www.sjkdt.org/text.asp?2009/20/5/766/55358


Full Text

 Introduction



One of the main goals of renal transplant team is increasing the survival of allograft and im計roving recipient quality of life. Therefore cy苞losporine is a drug of special interest in this population. [1] Although cyclosporine initially seemed to have improved the survival of graf負ed organ and recipient, it has some side effects which may adversely affect the life quality. Independent from its effect on immune sys負em, Cyclosporine has some side effects which are usually ignored.

Since serum Mg is not routinely tested in renal transplant recipients and some metabolic complications are attributed to hypomagne貞emia in some studies, we have attempted to determine the rate of hypomagnesemia in renal transplant recipients who were taking cyclos計orine and also the correlate it with other metabolic complications.

 Material and Methods



This cross- sectional study was performed on 157 living unrelated renal transplant recipients who were treated by cyclosporine and their re要al functions were stable for at least 6 months (serum creatinine [3] In their study 198 patients entry criteria were the same as our study except a higher serum creatinine of [4]

In our study, serum Mg level had an inverse significant correlation with age of patients (P= 0.042, r= -0.52) and hypomagnesemia should therefore be watched more closely in reci計ients older than 50 years of age. Serum Mg and serum creatinine had an inverse significant correlation in this study as well (P= 0.21, r= - 0.61) contrary to the study of MazzaFerro. [4] In other similar studies by Asai T from Japan, pres苞ribing Mg supplements and correcting hypo衫agnesemia in recipients taking cyclosporine prevented cyclosporine nephrotoxicity. [5] These findings suggest that hypomagnesemia, the same as increased blood creatinine, can be a poor prognostic criterion for graft survival. More studies about correlation of hypomagnesemia and renal function can determine the role of serum Mg in prognosis of renal function.

In our study, systolic and diastolic blood pre貞sure in hypomagnesemic patients were higher (in order P= 0.002 and r- 0.48 and; P= 0.006 and r= 0.50 respectively)

Our findings, in comparison with those of Thakur study from India on 31 renal transplant recipients, are similar. [6] Pere AK, in their expe訃imental models showed that Mg supplemen負ation in hypomagnesemic model, using cyclos計orine, did significantly reduce hypertension. [7]

We found significant correlation between LDL only and serum Mg levels compared to study by Bharat where hypomagnesemia was asso苞iated with higher cholesterol, LDL and total cholesterol/HDL ratio. [3] In yet another study by Markell, there was a significant correlation bet趴een hypercholesterolemia, cyclosporine dose and serum Mg levels. [8]

In our study patients serum Mg had a sig要ificant inverse correlation with blood sugar amounts (P= 0.03 and r= 0.61). Morever, in hypomagnesemic recipients, mean blood sugar was higher than recipients with normal blood Mg similar to reported by Vannini et al. [9]

We found no significant correlation between blood calcium, phosphorus and serum Magne貞ium similar to other reports. [10] There are other reports however such as by Cavdar et al showing that hypomagnesemia accompanying hypocal苞emia is produced in patients receiving cyclos計orine that was not corrected without Mg supplementation.

The results of our study showed that patient's serum Mg have a moderate, inverse significant correlation with blood uric acid (P [8],[9],[10] In conclusion, the results of our study suggest that measurement of total and ionized Mg level in addition to routine bio苞hemical tests in patients with recipients of renal allograft being treated with cyclosporine should be routine. It will help to detect hypo衫agnesemic patients early and prevent its metabolic complication.

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