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Magnesium in Chronic Kidney Disease: Should We Care?
van de Wal-Visscher E.R. · Kooman J.P. · van der Sande F.M
теперь некоторые выдержки по русски.........
Какие механизмы могут обеспечить защитные свойства Магния?
Магний играет важную роль во многих процессах, таких как транспортные функции, передача сигналов, активность ферментов, энергетический обмен, синтез нуклеиновых кислот и белков, а также нервно-мышечных и сосудистых процессах и костном метаболизме [1, 2, 11].
Существует несколько механизмов, которые могут объяснить повышенный риск сердечно-сосудистых заболеваний у пациентов с гипомагниемией [37]. Магний обладает анти атеросклеротическим действием, которое осуществляется частично за счет его противовоспалительных и антиоксидантных свойств; путем ингибирования пролиферации эндотелия, повышения активности ингибитора активатора плазминогена-1 и молекулы адгезии сосудистых клеток-1, дефицит магния способствует развитию эндотелиальной дисфункции [20, 43-46]. Исследование Риска атеросклероза в популяциях - Aterosclerosis Risk in Communities (ARIC), проведенное на большой когорте пациентов с нормальной функцией почек, показало в 1,6 раза больший риск развития ХБП и в 2,4 раза больший риск развития ТХПН при уровне магния в сыворотке крови <0,7 ммоль / л, не зависимо от других факторов риска, тем самым выделяя эффект повреждения эндотелия [47].
Дефицит магния способствует образованию гидроксиапатита и кальцификации гладкомышечных клеток сосудов [48-50]. С другой стороны, хроническая гипермагниемия у диализных больных играет важную роль в генезе адинамической болезни костей, хотя точные механизмы ее возникновения пока не ясны.
И наконец, дефицит Mg тесно связан с инсулинорезистентностью и метаболическим синдромом [51]. Магний является важным кофактором для нескольких ферментов, участвующих в метаболизме глюкозы. Сообщалось, что повышенное употребление магния в пище показало выраженную связь с более низкой частотой развития СД 2 типа [52-54].
Ссылки:
1. Jahnen-Dechent W, Ketteler M: Magnesium basics. Clin Kidney J 2012; 5(suppl 1):i3–i14.
2. Cunningham J, Rodríguez M, Messa P: Magnesium in chronic kidney disease stages 3 and 4 and in dialysis patients. Clin Kidney J 2012; 5(suppl 1):i39–i51.
3. Quamme GA, de Rouffignac C: Epithelial magnesium transport and regulation by the kidney. Front Biosci 2000; 5:D694–D711.
4. Jones JE, Manalo R, Flink EB: Magnesium requirements in adults. Am J Clin Nutr 1967; 20: 632–635.
5. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes/Food Nutrition Board/Institute of Medicine. 1997 Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, National Academies Press, 1997.
6. Lewellen TK, Nelp WB, Murano R, Hinn GM, Chesnut CH 3rd: CH: Absolute measurement of total-body calcium by the Ar-37 method-preliminary results: concise communication. J Nucl Med 1977; 18: 929–932.
7. Elin RJ: Assessment of magnesium status for diagnosis and therapy. Magnes Res 2010; 23:S194–S198.
8. de Baaij JH, Hoenderop JG, Bindels RJ: Regulation of magnesium balance: lessons learned from human genetic disease. Clin Kidney J 2012; 5(suppl 1):i15–i24.
9. Huijgen HJ, Van Ingen HE, Kok WT, Sanders GT: Magnesium fractions in serum of healthy individuals and CAPD patients, measured by an ion-selective electrode and ultrafiltration. Clin Biochem 1996; 29: 261–266.
10. Felsenfeld AJ, Levine BS, Rodriguez M: Pathophysiology of calcium, phosphorus, and magnesium dysregulation in chronic kidney disease. Semin Dial 2015; 28: 564–577.
11. Saris NE, Mervaala E, Karppanen H, Khawaja JA, Lewenstam A: Magnesium. An update on physiological, clinical and analytical aspects. Clin Chim Acta 2000; 294: 1–26.
12. Quamme GA: Recent developments in intestinal magnesium absorption. Curr Opin Gastroenterol 2008; 24: 230–235.
13. Massy ZA, Nistor I, Apetrii M, Brandenburg VM, Bover J, Evenepoel P, Goldsmith D, Mazzaferro S, Urena-Torres P, Vervloet MG, Cozzolino M, Covic A, Era-Edta OB: Magnesium-based interventions for normal kidney function and chronic kidney disease. Magnes Res 2016; 29: 126–140.
14. Quamme GA: Control of magnesium transport in the thick ascending limb. Am J Physiol 1989; 256(2 pt 2):F197–F210.
15. Graham LA, Caesar JJ, Burgen AS: Gastrointestinal absorption and excretion of Mg 28 in man. Metabolism 1960; 9: 646–659.
16. Topf JM, Murray PT: Hypomagnesemia and hypermagnesemia. Rev Endocr Metab Disord 2003; 4: 195–206.
17. Groenestege WM, Hoenderop JG, van den Heuvel L, Knoers N, Bindels RJ: The epithelial Mg2+ channel transient receptor potential melastatin 6 is regulated by dietary Mg2+ content and estrogens. J Am Soc Nephrol 2006; 17: 1035–1043.
18. Coburn JW, Popovtzer MM, Massry SG, Kleeman CR: The physicochemical state and renal handling of divalent ions in chronic renal failure. Arch Intern Med 1969; 124: 302–311.
19. Massry SG. Magnesium homeostasis in patients with renal failure. Contrib Nephrol 1984; 38: 175–84.
20. M de Francisco AL, Rodríguez M: Magnesium – its role in CKD. Nefrologia 2013; 33: 389–399.
21. Alhosaini M, Walter JS, Singh S, Dieter RS, Hsieh A, Leehey DJ: Hypomagnesemia in hemodialysis patients: role of proton pump inhibitors. Am J Nephrol 2014; 39: 204–209.
22. Ejaz AA, McShane AP, Gandhi VC, Leehey DJ, Ing TS: Hypomagnesemia in continuous ambulatory peritoneal dialysis patients dialyzed with a low-magnesium peritoneal dialysis solution. Perit Dial Int 1995; 15: 61–64.
23. Hashizume N, Mori M: An analysis of hypermagnesemia and hypomagnesemia. Jpn J Med 1990; 29: 368–372.
24. Brannan PG, Vergne-Marini P, Pak CY, Hull AR, Fordtran JS: Magnesium absorption in the human small intestine. Results in normal subjects, patients with chronic renal disease, and patients with absorptive hypercalciuria. J Clin Invest 1976; 57: 1412–1418.
25. Mitsopoulos E, Griveas I, Zanos S, Anagnostopoulos K, Giannakou A, Pavlitou A, Sakellariou G: Increase in serum magnesium level in haemodialysis patients receiving sevelamer hydrochloride. Int Urol Nephrol 2005; 37: 321–328.
26. Legette LL, Lee W, Martin BR, Story JA, Campbell JK, Weaver CM: Prebiotics enhance magnesium absorption and inulin-based fibers exert chronic effects on calcium utilization in a postmenopausal rodent model. J Food Sci 2012; 77:H88–H94.
27. al-Ghamdi SM, Cameron EC, Sutton RA: Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis 1994; 24: 737–752.
28. Randall RE Jr, Cohen MD, Spray CC Jr, Rossmeisl EC: Hypermagnesemia in renal failure. Etiology and toxic manifestations. Ann Intern Med 1964; 61: 73–88.
29. Zehender M, Meinertz T, et al: Antiarrhythmic effects of increasing the daily intake of magnesium and potassium in patients with frequent ventricular arrhythmias. J Am Coll Cardiol 1997; 29: 1028–1034.
30. Altura BM, Altura BT: Magnesium in cardiovascular biology. Sci Am Sci Med 1995; 2: 28–37.
31. Drueke TBLB: Magnesium homeostasis and disorders of magnesium metabolism; in Feehally JFJ, Johnson RJ (eds): Comprehensive Clin Nephrol. Philadelphia, Mosby, 2007, pp 136–138.
32. Ishimura E, Okuno S, Kitatani K, Tsuchida T, Yamakawa T, Shioi A, Inaba M, Nishizawa Y: Significant association between the presence of peripheral vascular calcification and lower serum magnesium in hemodialysis patients. Clin Nephrol 2007; 68: 222–227.
33. Tzanakis I, Pras A, Kounali D, Mamali V, Kartsonakis V, Mayopoulou-Symvoulidou D, Kallivretakis N: Mitral annular calcifications in haemodialysis patients: a possible protective role of magnesium. Nephrol Dial Transplant 1997; 12: 2036–2037.
34. Tzanakis I, Virvidakis K, Tsomi A, Mantakas E, Girousis N, Karefyllakis N, Papadaki A, Kallivretakis N, Mountokalakis T: Intra- and extracellular magnesium levels and atheromatosis in haemodialysis patients. Magnes Res 2004; 17: 102–108.
35. Reffelmann T, Dörr M, Ittermann T, Schwahn C, Völzke H, Ruppert J, Robinson D, Felix SB: Low serum magnesium concentrations predict increase in left ventricular mass over 5 years independently of common cardiovascular risk factors. Atherosclerosis 2010; 213: 563–569.
36. Reffelmann T, Ittermann T, Dörr M, Völzke H, Reinthaler M, Petersmann A, Felix SB: Low serum magnesium concentrations predict cardiovascular and all-cause mortality. Atherosclerosis 2011; 219: 280–284.
37. Massy ZA, Drueke TB: Magnesium and outcomes in patients with chronic kidney disease: focus on vascular calcification, atherosclerosis and survival. Clin Kidney J 2012; 5(suppl 1): i52–i61.
38. Ishimura E, Okuno S, Yamakawa T, Inaba M, Nishizawa Y: Serum magnesium concentration is a significant predictor of mortality in maintenance hemodialysis patients. Magnes Res 2007; 20: 237–244.
39. Sakaguchi Y, Fujii N, Shoji T, Hayashi T, Rakugi H, Isaka Y: Hypomagnesemia is a significant predictor of cardiovascular and non-cardiovascular mortality in patients undergoing hemodialysis. Kidney Int 2014; 85: 174–181.
40. João Matias P, Azevdo A, Laranjinha I, et al: Lower serum magnesium is associated with cardiovascular risk factors and mortality in haemodialysis patients. Blood Purif 2014; 38: 244–252.
41. Chakraborti S, Chakraborti T, Mandal M, Mandal A, Das S, Ghosh S: Protective role of magnesium in cardiovascular diseases: a review. Mol Cell Biochem 2002; 238: 163–179.
42. Lacson E Jr, Wang W, Ma L, Passlick-Deetjen J: Serum magnesium and mortality in hemodialysis patients in the United States: a Cohort study. Am J Kidney Dis 2015; 66: 1056–1066.
43. Maier JA, Malpuech-Brugère C, Zimowska W, Rayssiguier Y, Mazur A: Low magnesium promotes endothelial cell dysfunction: implications for atherosclerosis, inflammation and thrombosis. Biochim Biophys Acta 2004; 1689: 13–21.
44. Van Laecke S, Van Biesen W, Vanholder R: Hypomagnesaemia, the kidney and the vessels. Nephrol Dial Transplant 2012; 27: 4003–4010.
45. Maier JA: Endothelial cells and magnesium: implications in atherosclerosis. Clin Sci (Lond) 2012; 122: 397–407.
46. Dickens BF, Weglicki WB, Li YS, Mak IT: Magnesium deficiency in vitro enhances free radical-induced intracellular oxidation and cytotoxicity in endothelial cells. FEBS Lett 1992; 311: 187–191.
47. Tin A, Grams ME, Maruthur NM, Astor BC, Couper D, Mosley TH, Selvin E, Coresh J, Kao WH: Results from the Atherosclerosis Risk in Communities study suggest that low serum magnesium is associated with incident kidney disease. Kidney Int 2015; 87: 820–827.
48. Rüfenacht HS, Fleisch H: Measurement of inhibitors of calcium phosphate precipitation in plasma ultrafiltrate. Am J Physiol 1984; 246(5 pt 2):F648–F655.
49. Montezano AC, Zimmerman D, Yusuf H, Burger D, Chignalia AZ, Wadhera V, van Leeuwen FN, Touyz RM: Vascular smooth muscle cell differentiation to an osteogenic phenotype involves TRPM7 modulation by magnesium. Hypertension 2010; 56: 453–462.
50. Kircelli F, Peter ME, Sevinc Ok E, Celenk FG, Yilmaz M, Steppan S, Asci G, Ok E, Passlick-Deetjen J: Magnesium reduces calcification in bovine vascular smooth muscle cells in a dose-dependent manner. Nephrol Dial Transplant 2012; 27: 514–521,
51. Belin RJ, He K: Magnesium physiology and pathogenic mechanisms that contribute to the development of the metabolic syndrome. Magnes Res 2007; 20: 107–129.
52. Schulze MB, Schulz M, Heidemann C, Schienkiewitz A, Hoffmann K, Boeing H: Fiber and magnesium intake and incidence of type 2 diabetes: a prospective study and meta-analysis. Arch Intern Med 2007; 167: 956–965.
53. Guerrero-Romero F, Simental-Mendía LE, Hernández-Ronquillo G, Rodriguez-Morán M: Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: a double-blind placebo-controlled randomized trial. Diabetes Metab 2015; 41: 202–207.
54. Guerrero-Romero F, Rodríguez-Morán M: Magnesium improves the beta-cell function to compensate variation of insulin sensitivity: double-blind, randomized clinical trial. Eur J Clin Invest 2011; 41: 405–410.
55. Alhosaini M, Leehey DJ: Magnesium and dialysis: the neglected cation. Am J Kidney Dis 2015; 66: 523–531.
56. Wyskida K, Witkowicz J, Chudek J, Więcek A: Daily magnesium intake and hypermagnesemia in hemodialysis patients with chronic kidney disease. J Ren Nutr 2012; 22: 19–26.
57. Li L, Streja E, Rhee CM, Mehrotra R, Soohoo M, Brunelli SM, Kovesdy CP, Kalantar-Zadeh K: Hypomagnesemia and mortality in incident hemodialysis patients. Am J Kidney Dis 2015; 66: 1047–1055.
58. Van Laecke S, Nagler EV, Verbeke F, Van Biesen W, Vanholder R: Hypomagnesemia and the risk of death and GFR decline in chronic kidney disease. Am J Med 2013; 126: 825–831.
59. Dousdampanis P, Trigka K, Fourtounas C: Hypomagnesemia, chronic kidney disease and cardiovascular mortality: pronounced association but unproven causation. Hemodial Int 2014; 18: 730–739.
60. Pletka P, Bernstein DS, Hampers CL, Merrill JP, Sherwood LM: Relationship between magnesium and secondary hyperparathyroidism during long-term hemodialysis. Metabolism 1974; 23: 619–630.
61. Takahashi S, Okada K, Yanai M: Magnesium and parathyroid hormone changes to magnesium-free dialysate in continuous ambulatory peritoneal dialysis patients. Perit Dial Int 1994; 14: 75–78.
62. Navarro JF, Mora C, Jiménez A, Torres A, Macía M, García J: Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients. Am J Kidney Dis 1999; 34: 43–48.
63. Kyriazis J, Kalogeropoulou K, Bilirakis L, Smirnioudis N, Pikounis V, Stamatiadis D, Liolia E: Dialysate magnesium level and blood pressure. Kidney Int 2004; 66: 1221–1231.
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Сообщение отредактировал Vadim - Воскресенье, 29.09.2019, 20:22 |
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