THE EFFECT OF THREE-MONTH MAGNESIUM REPLACEMENT ON PROTEINURIA IN HYPOMAGNESEMIC PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract

Objective: Metabolic disorders such as diabetes mellitus, metabolic syndrome, and hypertension are frequently observed in patients with chronic kidney disease (CKD), and hypomagnesemia is considered to play a role in their pathogenesis. Reduced serum magnesium (Mg) levels are associated with higher mortality rates and a decline in estimated glomerular filtration rate (eGFR) among individuals with CKD. Proteinuria represents an independent determinant of CKD progression, and its improvement may help decelerate renal decline. This study evaluated the effect of a three-month Mg replacement regimen on proteinuria in stage 1–4 CKD patients with hypomagnesemia. Methods: Sixty-six stage 1–4 CKD patients were enrolled. Serum Mg and spot urine protein/creatinine ratio (PCR) were measured at baseline and at month 3. Patients were divided into hypomagnesemic (n=25) and normomagnesemic (n=41) groups. The hypomagnesemic group received 365 mg/day elemental Mg and a Mg-rich diet under dietitian supervision, whereas the normomagnesemic group received standard CKD management. Statistical analyses were performed with SPSS software, and p-values below 0.05 were regarded as significant. Results: In the normomagnesemic group, serum Mg and PCR levels showed no significant change (p>0.05). In the hypomagnesemic group, serum Mg increased significantly (p=0.0001), and PCR decreased markedly compared with baseline (p=0.0001). Conclusion: A three-month Mg replacement regimen significantly reduced proteinuria in hypomagnesemic CKD patients. Mg deficiency may represent a modifiable factor influencing CKD progression. Larger prospective studies are needed to clarify the sustained renal and metabolic effects of Mg supplementation.