Hypermagnesemia reduces hip fracture risk in hemodialysis patients

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Hypermagnesemia reduces hip fracture risk in hemodialysis patients

In patients undergoing hemodialysis (HD), a mild hypermagnesemia is associated with a lower risk of hip fracture, report Japanese researchers (Sakaguchi Y et al, Magnesium and Risk of Hip Fracture among Patients Undergoing Hemodialysis. J Am Soc Nephrol 2018;29:991-999).

Magnesium is, of course, known as an essential mineral for bone metabolism, but the relationship between magnesium levels and the risk of fractures is only poorly understood. The present cohort study included approximately 113,500 HD patients with no history of hip fracture and analyzed the association between serum magnesium levels and the risk of incident hip fracture.

In total, 2,305 (2%) new hip fractures occurred during the 2-year follow-up. 

The crude incidence rate was significantly higher among patients in the lower quartiles of serum magnesium levels (2.63%, 2.08%, 1.76%, and 1.49% in Q1–Q4, respectively; P<0.001 for trend).

Patients in Q1 had a 1.23-fold higher risk for hip fracture than those in Q4 (95% confidence interval, 1.06 to 1.44; P < 0.01, after adjusting for demographic and clinical factors).

Similarly, the risk of hip fracture was higher among patients in the lower magnesium quartiles.

The population-attributable fraction of serum magnesium level for incident hip fractures was 13.7% (95% confidence interval, 3.7% to 22.7%). This, comment the authors, was much higher than that of serum calcium, serum phosphate, and parathyroid hormone levels. Their conclusion: Mild hypermagnesemia might be beneficial for patients undergoing hemodialysis, as it is associated with a lower risk of hip fracture.

Link to the study: http://jasn.asnjournals.org/content/29/3/991.abstract