慢性肾脏病患者血镁紊乱及影响的研究进展

Research progress on serum magnesium disorder and its effects in patients with chronic kidney disease

血镁紊乱对慢性肾脏病(CKD)的影响在近年研究中逐渐被证实。目前认为,镁稳态有赖于饮食摄入、胃肠道吸收及肾代谢共同维持,近年提出CKD患者使用的透析液镁浓度与药物(尤其是质子泵抑制剂)对镁稳态的影响不容忽视。尽管镁离子对CKD的影响机制未被完全阐明,但近期研究提示镁离子缺乏可能加重CKD患者高血压及血管钙化,影响矿物质代谢,导致病死率增高;而不同镁基结合剂的应用,如柠檬酸镁,醋酸钙/碳酸镁,氧化镁的应用是否有助于减轻低镁水平对CKD的影响则有待更多研究证实。文章从CKD患者的镁紊乱,镁与高血压、血管钙化以及矿物质代谢等方面的研究进行综述。

The effect of blood magnesium disorder on chronic kidney disease(CKD)has been gradually confirmed in recent years. At present,magnesium homeostasis depends on dietary intake,gastrointestinal absorption and kidney metabolism. In recent years,it has been proposed that the magnesium concentration of dialysate and the influence of drugs(especially proton pump inhibitors)on magnesium homeostasis cannot be ignored in the treatment of CKD patients. Although the mechanism of the effect of magnesium on CKD has not been fully elucidated,recent studies suggest that magnesium deficiency may aggravate hypertension and vascular calcification in CKD patients,affecting mineral metabolism,leading to increased mortality. The application of different magnesiumbased binders,such as magnesium citrate,calcium acetate/magnesium carbonate,and magnesium oxide,can help to alleviate the effect of low magnesium levels on CKD,which needs further research.