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IDH was defined according to kidney disease outcomes quality initiative (K/DOQI) guidelines as a decrease in systolic blood pressure (SBP) by ≥20 mmHg or a decrease in mean arterial pressure (MAP) by ≥10 mmHg associated with clinical symptoms during HD. Multivariate logistic regression was employed to explore independent risk factors for IDH. [2] => Among 423 patients recruited, 175 patients (41.4%) suffered from IDH. Compared with those with non-IDH, patients with IDH presented higher predialysis serum Mg levels. Univariate correlation analysis showed that predialysis serum Mg level was negatively correlated with SBP at 3 hours, 4 hours after dialysis (3 hours SBP r = -0.134 P = 0.006, 4 hours SBP r = -0.142 P = 0.003) and was positively correlated with the differences of blood pressure (BP) (SBP and MAP) (△SBP r = 0.195 P < 0.001, △MAP r = 0.155, P = 0.001). After adjustment for predialysis blood urea nitrogen, platelet distribution width, cardiac troponin T, fasting blood glucose, β2-microglobulin, and predialysis MAP, multivariate logistic regression analysis demonstrated that predialysis serum Mg level was one of the independent risk factors for IDH (odds ratio [95% confidence interval-CI]: 7.154 (1.568-32.637); P = 0.011). In addition, Mg levels of 1.15 mmol/L or higher were associated with a high incidence of IDH. 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Is there an association between intradialytic hypotension and serum magnesium changes? Hemodial Int. 2010;14:492-497. ) [14] => SimpleXMLElement Object ( [Citation] => Friedman HS, Nguyen TN, Mokraoui AM, Barbour RL, Murakawa T, Altura BM. Effects of magnesium chloride on cardiovascular hemodynamics in the neurally intact dog. J Pharmacol Exp Ther. 1987;243:126-130. ) [15] => SimpleXMLElement Object ( [Citation] => Yang ZW, Gebrewold A, Nowakowski M, Altura BT, Altura BM. Mg(2+)-induced endothelium-dependent relaxation of blood vessels and blood pressure lowering: Role of NO. Am J Physiol Regul Integr Comp Physiol. 2000;278:R628-R639. ) [16] => SimpleXMLElement Object ( [Citation] => Barbagallo M, Dominguez LJ, Galioto A, Pineo A, Belvedere M. Oral magnesium supplementation improves vascular function in elderly diabetic patients. Magnes Res. 2010;23:131-137. ) [17] => SimpleXMLElement Object ( [Citation] => Houston M. The role of magnesium in hypertension and cardiovascular disease. 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J Gen Physiol. 2008;132:429-446. ) ) ) ) ) [1] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => MEDLINE [Owner] => NLM ) [PMID] => 25975966 [DateCompleted] => SimpleXMLElement Object ( [Year] => 2015 [Month] => 11 [Day] => 17 ) [DateRevised] => SimpleXMLElement Object ( [Year] => 2018 [Month] => 11 [Day] => 13 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print-Electronic ) [Journal] => SimpleXMLElement Object ( [ISSN] => 1523-6838 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 66 [Issue] => 3 [PubDate] => SimpleXMLElement Object ( [Year] => 2015 [Month] => Sep ) ) [Title] => American journal of kidney diseases : the official journal of the National Kidney Foundation [ISOAbbreviation] => Am J Kidney Dis ) [ArticleTitle] => Association of Predialysis Calculated Plasma Osmolarity With Intradialytic Blood Pressure Decline. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 499-506 ) [ELocationID] => Array ( [0] => 10.1053/j.ajkd.2015.03.028 [1] => S0272-6386(15)00610-1 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => The rapid reduction in plasma osmolality during hemodialysis (HD) may induce temporary gradients that promote the movement of water from the extracellular to the intracellular compartment, predisposing to the development of intradialytic hypotension (IDH). [1] => Observational cohort study. [2] => 3,142 prevalent patients receiving thrice-weekly HD from a single dialysis provider organization. [3] => Predialysis calculated plasma osmolarity (calculated after the 2-day interval as 2 × serum sodium + serum urea nitrogen/2.8 + serum glucose/18). [4] => Magnitude of systolic blood pressure (SBP) decline (predialysis SBP - nadir intradialytic SBP) and risk of IDH (SBP decline > 35 or nadir SBP < 90 mm Hg). [5] => Unadjusted and multivariable-adjusted generalized linear models were fit to estimate the association of calculated osmolarity with intradialytic SBP decline and the odds of developing IDH. [6] => Mean age of participants was 62.6±15.2 (SD) years, 57.1% were men, and 61.0% had diabetes. Mean predialysis calculated osmolarity during follow-up was 306.4 ± 9.5 mOsm/L. After case-mix adjustment, each 10-mOsm/L increase in predialysis calculated osmolarity was associated with 1.48 (95% CI, 0.86-2.09) mm Hg (P < 0.001) greater decline in intradialytic SBP and 10% greater odds of IDH (OR, 1.10; 95% CI, 1.05-1.15). In adjusted models, lower predialysis sodium and higher serum urea nitrogen and serum glucose levels were associated with greater decline in intradialytic SBP. [7] => Measured serum osmolality, timing of changes in intradialytic osmolality, dialysate osmolality, and dialysate temperature were not available. [8] => Higher predialysis calculated osmolarity is associated with greater decline in intradialytic SBP and greater risk of IDH in maintenance HD patients. Strategies to minimize rapid shifts in osmolality should be tested prospectively to minimize excess SBP decline in susceptible patients. ) [CopyrightInformation] => Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Mc Causland [ForeName] => Finnian R [Initials] => FR [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: fmccausland@partners.org. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Waikar [ForeName] => Sushrut S [Initials] => SS [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. ) ) ) ) [Language] => eng [GrantList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Grant] => Array ( [0] => SimpleXMLElement Object ( [GrantID] => DK075941 [Acronym] => DK [Agency] => NIDDK NIH HHS [Country] => United States ) [1] => SimpleXMLElement Object ( [GrantID] => K23 DK102511 [Acronym] => DK [Agency] => NIDDK NIH HHS [Country] => United States ) [2] => SimpleXMLElement Object ( [GrantID] => U01DK085660 [Acronym] => DK [Agency] => NIDDK NIH HHS [Country] => United States ) [3] => SimpleXMLElement Object ( [GrantID] => K23 DK075941 [Acronym] => DK [Agency] => NIDDK NIH HHS [Country] => 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Object ( [ArticleId] => Array ( [0] => 25975966 [1] => S0272-6386(15)00610-1 [2] => 10.1053/j.ajkd.2015.03.028 [3] => PMC4782777 [4] => NIHMS677574 ) ) [ReferenceList] => SimpleXMLElement Object ( [Reference] => Array ( [0] => SimpleXMLElement Object ( [Citation] => Nephron Clin Pract. 2004;97(1):c23-30 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 15153764 ) ) [1] => SimpleXMLElement Object ( [Citation] => Kidney Int. 2004 Sep;66(3):1212-20 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 15327420 ) ) [2] => SimpleXMLElement Object ( [Citation] => Can J Physiol Pharmacol. 1967 Jan;45(1):129-47 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 6030390 ) ) [3] => SimpleXMLElement Object ( [Citation] => Kidney Int. 1973 Sep;4(3):177-87 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 4750910 ) ) [4] => SimpleXMLElement Object ( [Citation] => N Engl J Med. 1974 Mar 21;290(12):650-3 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 4813726 ) ) [5] => SimpleXMLElement Object ( [Citation] => Kidney Int. 1973 May;3(5):327-33 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 4792047 ) ) [6] => SimpleXMLElement Object ( [Citation] => Proc Eur Dial Transplant Assoc. 1978;15:239-44 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 740668 ) ) [7] => SimpleXMLElement Object ( [Citation] => Kidney Int. 1980 Oct;18(4):480-8 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 7230611 ) ) [8] => SimpleXMLElement Object ( [Citation] => Clin Nephrol. 1985 Jun;23(6):299-302 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 4028528 ) ) [9] => SimpleXMLElement Object ( [Citation] => Am J Nephrol. 2013;38(1):78-90 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 23838386 ) ) [10] => SimpleXMLElement Object ( [Citation] => Nephrol Dial Transplant. 2012 Oct;27(10):3935-42 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 22561583 ) ) [11] => SimpleXMLElement Object ( [Citation] => Am J Nephrol. 2012;36(2):168-74 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 22846598 ) ) [12] => SimpleXMLElement Object ( [Citation] => Blood Purif. 2012;33(4):317-23 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 22699819 ) ) [13] => SimpleXMLElement Object ( [Citation] => Nephrol Dial Transplant. 2012 Apr;27(4):1613-8 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 21891777 ) ) [14] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 2012 Mar;59(3):409-18 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 22209553 ) ) [15] => SimpleXMLElement Object ( [Citation] => Nephrol Dial Transplant. 2012 Feb;27(2):796-803 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 21633094 ) ) [16] => SimpleXMLElement Object ( [Citation] => Nephrol Dial Transplant. 2007 Apr;22(4):1184-9 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 17272314 ) ) [17] => SimpleXMLElement Object ( [Citation] => Nephrol Dial Transplant. 2005 Sep;20(9):1984-8 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 15985519 ) ) [18] => SimpleXMLElement Object ( [Citation] => J Am Soc Nephrol. 2005 Jan;16(1):237-46 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 15563561 ) ) [19] => SimpleXMLElement Object ( [Citation] => Lancet. 1962 Feb 24;1(7226):410-1 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 14455152 ) ) [20] => SimpleXMLElement Object ( [Citation] => Biomed Pharmacother. 1998;52(4):166-8 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 9755811 ) ) [21] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 1997 May;29(5):669-77 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 9159299 ) ) [22] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 1996 Jul;28(1):1-13 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 8712203 ) ) [23] => SimpleXMLElement Object ( [Citation] => J Am Soc Nephrol. 1995 Nov;6(5):1329-41 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 8589306 ) ) [24] => SimpleXMLElement Object ( [Citation] => ASAIO Trans. 1991 Oct-Dec;37(4):649-52 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 1768504 ) ) [25] => SimpleXMLElement Object ( [Citation] => Am J Nephrol. 2013;38(5):388-96 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 24192428 ) ) [26] => SimpleXMLElement Object ( [Citation] => J Am Soc Nephrol. 2015 Mar;26(3):724-34 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 25270068 ) ) [27] => SimpleXMLElement Object ( [Citation] => J Am Soc Nephrol. 2008 Jan;19(1):8-11 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 18178796 ) ) [28] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 2008 Aug;52(2):294-304 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 18562062 ) ) [29] => SimpleXMLElement Object ( [Citation] => Hemodial Int. 2009 Jul;13(3):293-300 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 19469884 ) ) [30] => SimpleXMLElement Object ( [Citation] => Hemodial Int. 2011 Jul;15(3):350-8 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 21658174 ) ) [31] => SimpleXMLElement Object ( [Citation] => Kidney Int. 2013 Oct;84(4):795-802 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 23783241 ) ) [32] => SimpleXMLElement Object ( [Citation] => Clin J Am Soc Nephrol. 2012 Jan;7(1):92-100 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 22052942 ) ) [33] => SimpleXMLElement Object ( [Citation] => Nephrol News Issues. 2013 Dec;27(13):18-21 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 24597066 ) ) [34] => SimpleXMLElement Object ( [Citation] => Am J Nephrol. 2014;39(2):100-9 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 24503523 ) ) [35] => SimpleXMLElement Object ( [Citation] => Am J Hypertens. 2014 Sep;27(9):1160-9 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 24651636 ) ) [36] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 2014 Nov;64(5):685-95 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 25156305 ) ) [37] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 2011 Dec;58(6):956-63 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 21875769 ) ) [38] => SimpleXMLElement Object ( [Citation] => J Am Soc Nephrol. 2011 Dec;22(12):2166-81 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 22034644 ) ) [39] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 2012 Feb;59(2):238-48 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 21944663 ) ) [40] => SimpleXMLElement Object ( [Citation] => Am J Kidney Dis. 2000 May;35(5):819-26 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 10793014 ) ) [41] => SimpleXMLElement Object ( [Citation] => Kidney Int. 2001 Mar;59(3):1175-81 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 11231376 ) ) [42] => SimpleXMLElement Object ( [Citation] => Int J Artif Organs. 2001 Dec;24(12):863-9 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 11831591 ) ) [43] => SimpleXMLElement Object ( [Citation] => Nephrol Dial Transplant. 2004 Apr;19(4):785-96 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 15031331 ) ) [44] => SimpleXMLElement Object ( [Citation] => Nephron Clin Pract. 2004;96(3):c82-7 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 15056990 ) ) ) ) ) ) [2] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => MEDLINE [Owner] => NLM ) [PMID] => 32331831 [DateCompleted] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 10 [Day] => 08 ) [DateRevised] => SimpleXMLElement Object ( [Year] => 2021 [Month] => 01 [Day] => 11 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print-Electronic ) [Journal] => SimpleXMLElement Object ( [ISSN] => 1523-6838 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 76 [Issue] => 3 [PubDate] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 09 ) ) [Title] => American journal of kidney diseases : the official journal of the National Kidney Foundation [ISOAbbreviation] => Am J Kidney Dis ) [ArticleTitle] => Predictors of Intradialytic Symptoms: An Analysis of Data From the Hemodialysis Study. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 331-339 ) [ELocationID] => Array ( [0] => S0272-6386(20)30528-X [1] => 10.1053/j.ajkd.2020.01.004 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => Most patients receiving maintenance hemodialysis (HD) experience adverse symptoms, which are associated with decreased quality of life. Despite decades of experience, our understanding of causes of HD symptoms remains limited. We aimed to identify modifiable patient- and HD-related predictors of intradialytic symptoms. [1] => Prospective cohort. [2] => We leveraged patient-level (n=1,838) and HD session-level (n=64,797) data from the Hemodialysis Trial. [3] => Pre-HD serum urea nitrogen (SUN) level, pre-HD systolic blood pressure (SBP), intradialytic SBP decline, and ultrafiltration rate (UFR). [4] => Intra-HD symptoms, including cramps, nausea, chest pain, headache, and lightheadedness. [5] => Random-effects logistic regression models. [6] => Overall, symptoms occurred in 10.7% of HD sessions. Higher pre-HD SUN level (per 10 mg/dL) was associated with higher adjusted odds of muscle cramping and lightheadedness (adjusted ORs [aORs] of 1.20 [95% CI, 1.17-1.22] and 1.13 [95% CI, 1.08-1.18], respectively). SBP decline (from the predialysis value to the dialysis session nadir, per each 10-mm Hg decrease) was associated with greater risk for muscle cramping, headache, chest pain, vomiting, and lightheadedness (the largest aORs were for the 2 latter symptoms: 1.24 [95% CI, 1.20-1.28] and 1.37 [95% CI, 1.33-1.42], respectively). Higher UFR (per 1 mL/kg/h) was associated with greater odds of cramping (aOR, 1.03; 95% CI, 1.02-1.03). Conversely, higher pre-HD SBP (per 10 mm Hg) was associated with reduced risk for vomiting (aOR, 0.88; 95% CI, 0.85-0.92) and lightheadedness (aOR, 0.82; 95% CI, 0.80-0.85). [7] => Measured osmolality, dialysate prescription data, and time stamps for symptom occurrence were not available. Clinical trial data may not be broadly generalizable. [8] => Higher pre-HD SUN level, UFR, pre-HD SBP, and SBP decline are independently associated with different patterns of adverse intradialytic symptoms. Recognition that different symptoms may have variable causes may allow tailoring of personalized treatments in future interventional studies. ) [CopyrightInformation] => Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Correa [ForeName] => Simon [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: scorreagaviria@bwh.harvard.edu. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Pena-Esparragoza [ForeName] => Jessy K [Initials] => JK [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Nephrology Section, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Scovner [ForeName] => Katherine M [Initials] => KM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Mc Causland [ForeName] => Finnian R [Initials] => FR [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. ) ) ) 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Hemodialysis international. International Symposium on Home Hemodialysis [ISOAbbreviation] => Hemodial Int ) [ArticleTitle] => Intradialytic changes of serum magnesium and their relation to hypotensive episodes in hemodialysis patients on different dialysates. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => S16-23 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Magnesium is a crucial mineral, involved in many important physiological processes. Magnesium plays a role of maintaining myocardial electrical stability in hemodialysis patients. Intradialytic hypotension is a common complication of dialysis and it is more common with acetate dialysate. The significance of the intradialytic changes of magnesium and their relation to parathyroid hormone (PTH) level and calcium changes during dialysis, and their relation to hypotensive episodes during dialysis are interesting. The aim of this work is to investigate the intradialytic changes of serum magnesium in chronic hemodialysis patients with different hemodialysis modalities and the relation to other electrolytes and to PTH, and also the relation to intradialytic hypotension. The present study was conducted on 20 chronic renal failure patients. All patients were on regular hemodialysis thrice weekly 4 hr each using acetate dialysate (group I). To study the effect of an acetate-based dialysate vs. a bicarbonate-based dialysate on acute changes of magnesium, calcium, phosphorus, and PTH during a hemodialysis session, the same patients were shifted to bicarbonate dialysis (group II). All patients were subjected to full history and clinical examination, predialysis laboratory assessment of blood urea nitrogen (BUN), serum creatinine, albumin, and hemoglobin, serial assessment of magnesium, calcium, phosphorus, and parathyroid hormone at the start of the hemodialysis session, 2 hr later, and at the end of the session, blood pH, and electrocardiogram (ECG) presession and postsession. All patients were urged to fix their dry weight, diet, and current medications. None of the patients had diabetes, neoplasia, liver disease, or cachexia, nor had they been recently on magnesium-containing drugs or previously parathyroidectomized. Hemodialysis sessions were performed by volumetric dialysis machines using the same electrolyte composition. Magnesium level significantly increased in the bicarbonate group at the end of dialysis (0 hr: 2.73+/-0.87, 2 hr: 3.21+/-1.1, and at 4 hr: 5.73+/-1.45 mg/dL, p value <0.01), while it significantly decreased in the acetate group (0 hr: 3.00+/-0.58, 2 hr: 2.26+/-0.39, 4 hr: 1.97+/-0.33 mg/dL, p value <0.01). Calcium level significantly increased in the bicarbonate group (p=0.024) but not in the acetate group. Phosphorus level significantly decreased in both acetate and bicarbonate groups. PTH level did not significantly change in either group, p value > or =0.05. Blood pH significantly increased, changing from acidic to alkaline pH, with both modalities of hemodialysis. ECG showed no significant changes during sessions with either type of dialysate. Hypotension was significantly higher in group I compared with group II (p=0.01), and this hypotension was positively correlated with a decrease in serum magnesium level in group I. Intradialytic changes in serum magnesium have no correlation with intradialytic changes in serum calcium or with PTH level. However, it was significantly correlated with hypotension during the dialysis session, especially with acetate dialysate. 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Role of magnesium in the risk of intradialytic hypotension among maintenance hemodialysis patients.

Hemodial Int 2020 Jul 12;24(3):351-358. Epub 2020 May 12.

Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai Institute of Kidney and Dialysis, Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai Medical Center of Kidney Disease, Shanghai, China.

Introduction: Intradialytic hypotension (IDH) is a common complication in end-stage renal disease patients on hemodialysis (HD). It has been documented that several factors contribute to IDH. However, the relationship between serum electrolytes and the occurrence of IDH remains unclear. Our study aims to investigate the role of serum magnesium (Mg) for the risk of IDH in maintenance HD patients.

Methods: The retrospective study included adults starting HD before January 2009 in the blood purification center, Zhongshan Hospital, Fudan University, and treated thrice weekly with standard bicarbonate dialysate by low-flux HD. Patients' characteristics including age and sex, laboratory test results were collected. IDH was defined according to kidney disease outcomes quality initiative (K/DOQI) guidelines as a decrease in systolic blood pressure (SBP) by ≥20 mmHg or a decrease in mean arterial pressure (MAP) by ≥10 mmHg associated with clinical symptoms during HD. Multivariate logistic regression was employed to explore independent risk factors for IDH.

Findings: Among 423 patients recruited, 175 patients (41.4%) suffered from IDH. Compared with those with non-IDH, patients with IDH presented higher predialysis serum Mg levels. Univariate correlation analysis showed that predialysis serum Mg level was negatively correlated with SBP at 3 hours, 4 hours after dialysis (3 hours SBP r = -0.134 P = 0.006, 4 hours SBP r = -0.142 P = 0.003) and was positively correlated with the differences of blood pressure (BP) (SBP and MAP) (△SBP r = 0.195 P < 0.001, △MAP r = 0.155, P = 0.001). After adjustment for predialysis blood urea nitrogen, platelet distribution width, cardiac troponin T, fasting blood glucose, β2-microglobulin, and predialysis MAP, multivariate logistic regression analysis demonstrated that predialysis serum Mg level was one of the independent risk factors for IDH (odds ratio [95% confidence interval-CI]: 7.154 (1.568-32.637); P = 0.011). In addition, Mg levels of 1.15 mmol/L or higher were associated with a high incidence of IDH.

Discussion: Our findings suggested that higher predialysis serum Mg level was one of the independent risk factors for IDH among maintenance hemodialysis (MHD patients).

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July 2020

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