Relationship between Serum Magnesium and Parathyroid Hormone Levels in Non-Dialysis Dependent Chronic Kidney Disease Patients
DOI:
https://doi.org/10.70749/ijbr.v3i6.2990Keywords:
Chronic kidney Disease, Serum Magnesium, Intact Parathyroid Hormone, Mineral Metabolism, Secondary Hyperparathyroidism.Abstract
Background: Chronic kidney disease–mineral and bone disorder reflects disrupted mineral handling and hormonal adaptation, culminating in secondary hyperparathyroidism. The association between serum magnesium and parathyroid hormone in non-dialysis chronic kidney disease (CKD) remains incompletely defined and warrants evaluation in relation to secondary hyperparathyroidism. Objective: To determine the correlation between serum magnesium and intact parathyroid hormone levels in CKD stage 4 and 5 patients. Method: This cross-sectional study was conducted at the Nephrology Outpatient Department, Lahore General Hospital, from June to December 2024. One hundred eighty-three adults aged 18–70 years with CKD stage 4 or 5 were enrolled using consecutive sampling. Serum magnesium and intact parathyroid hormone was measured. Results: The mean age was 49.3 ± 11.4 years and mean disease duration was 5.4 ± 2.0 years. Mean serum magnesium was 1.86 ± 0.19 mg/dL and mean intact parathyroid hormone was 268.7 ± 142.6 pg/mL. Hypomagnesemia was present in 19.7% of patients. Serum magnesium correlated inversely with intact parathyroid hormone (r = −0.176, p = 0.017), serum calcium (r = −0.469, p <0.001) and alkaline phosphatase (r = −0.478, p <0.001). Intact parathyroid hormone correlated with estimated glomerular filtration rate (r = −0.482, p <0.001) and alkaline phosphatase (r = 0.563, p <0.001). Conclusion: A weak inverse correlation between serum magnesium and intact parathyroid hormone was observed in non-dialysis chronic kidney disease patients, with lower magnesium levels associated with altered mineral metabolism patterns.
Downloads
References
1. Kovesdy, C. P. (2022). Epidemiology of chronic kidney disease: An update 2022. Kidney International Supplements, 12(1), 7-11.
https://doi.org/10.1016/j.kisu.2021.11.003
2. Imtiaz, S., & Alam, A. (2023). Epidemiology and demography of chronic kidney disease in pakistan- A review of Pakistani literature. Pakistan Journal of Kidney Diseases, 7(1), 2-7.
https://doi.org/10.53778/pjkd71209
3. Dhondup, T., & Qian, Q. (2017). Acid-base and electrolyte disorders in patients with and without chronic kidney disease: An update. Kidney Diseases, 3(4), 136-148.
https://doi.org/10.1159/000479968
4. Cunningham, J., Rodriguez, M., & Messa, P. (2012). Magnesium in chronic kidney disease stages 3 and 4 and in dialysis patients. Clinical Kidney Journal, 5(Suppl 1), i39-i51.
https://doi.org/10.1093/ndtplus/sfr166
5. Peride, I., Tiglis, M., Neagu, T. P., Niculae, A., & Checherita, I. A. (2022). Magnesium—A more important role in CKD–MBD than we thought. Diagnostics, 12(4), 880.
https://doi.org/10.3390/diagnostics12040880
6. Brown, E. M., & Chen, C. J. (1989). Calcium, magnesium and the control of PTH secretion. Bone and Mineral, 5(3), 249-257.
https://doi.org/10.1016/0169-6009(89)90003-2
7. Mohammed El okely, A., Hosney Zahran, M., & Hegab, A. (2020). Correlation between serum magnesium and parathyroid hormone in hemodialysis patients. Benha Medical Journal, 0(0), 0-0.
https://doi.org/10.21608/bmfj.2020.105259
8. Baradaran, A., & Nasri, H. (2006). Correlation of serum magnesium with serum parathormone levels in patients on regular hemodialysis. Saudi journal of kidney diseases and transplantation, 17(3), 344-350.
https://journals.lww.com/sjkd/fulltext/2006/17030/Correlation_of_Serum_Magnesium_with_Serum.6.aspx
9. Fooladgar, M., Malekpour, A., Asgari-Savadjani, S., & Mardani, S. (2017). Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients. Journal of Parathyroid Disease, 6(1), 13-15.
https://doi.org/10.15171/jpd.2018.05
10. Carneiro Dias, R. S., José de Araújo Brito, D., Milhomem dos Santos, E., Cadilhe de Oliveira Costa, R., Martins Melo Fontenele, A., Viana Hortegal Furtado, E., Santos Lages, J., Miranda dos Santos, A., Freitas Santos, E. J., De Lima Carneiro, É. C., Cruz Diniz, M. C., Trindade Barbosa, C. D., Costa de Sales Muniz, A., Teixeira da Cunha França, A. K., Salgado Filho, N., Vianna Araújo, D., & Bernardo-Filho, M. (2020). Correlation between parathyroid hormone levels with urinary magnesium excretion in patients with non-dialysis dependent chronic kidney Disease. International Journal of Nephrology and Renovascular Disease, 13, 341-348.
https://doi.org/10.2147/ijnrd.s282106
11. Albert, A., Hinkel, U. P., Bohlender, T., Stieger, P., Braun-Dullaeus, R. C., & Albert, C. (2025). Paradoxical inadequate parathyroid hormone secretion secondary to severe Hypomagnesemia: A review of the literature. Kidney Medicine, 7(8), 101046.
https://doi.org/10.1016/j.xkme.2025.101046
12. Na, D., Tao, G., Shu-Ying, L., Qin-Yi, W., Xiao-Li, Q., Yong-Fang, L., Yang-Na, O., Zhi-Feng, S., & Yan-Yi, Y. (2021). Association between hypomagnesemia and severity of primary hyperparathyroidism: A retrospective study. BMC Endocrine Disorders, 21(1).
https://doi.org/10.1186/s12902-021-00838-y
13. Owiredu, W. K. B. A., Ephraim, R. K. D., Eghan, B. A. J., Nafiu, A., & Edwin, F. L. (2012). Relationship between parathyroid hormone and electrolytes in chronic kidney disease. E3 Journal of Medical Research, 1(8), 103-111.
https://www.e3journals.org/cms/articles/1348631804_Gallay%20Proof_EJMR-12-037.pdf
14. Ghosh, B., Brojen, T., Banerjee, S., Singh, N., Singh, S., Sharma, O., & Prakash, J. (2012). The high prevalence of chronic kidney disease-mineral bone disorders: A hospital-based cross-sectional study. Indian Journal of Nephrology, 22(4), 285.
https://doi.org/10.4103/0971-4065.101249
15. Galán Carrillo, I., Vega, A., Goicoechea, M., Shabaka, A., Gatius, S., Abad, S., & López-Gómez, J. M. (2021). Impact of serum magnesium levels on kidney and cardiovascular prognosis and mortality in CKD patients. Journal of Renal Nutrition, 31(5), 494-502.
https://doi.org/10.1053/j.jrn.2020.09.004
16. Carmen, del, Lorena Cuenca Bermejo, Veronese, N., Emiliano Fernández Villalba, María, A., Karolina Kublickiene, Raparelli, V., Norris, C. M., Kautzky-Willer, A., Pilote, L., Barbagallo, M., Dominguez, L., & María Trinidad Herrero. (2023). Magnesium in Kidney Function and Disease—Implications for Aging and Sex—A Narrative Review. Nutrients, 15(7), 1710–1710.
https://doi.org/10.3390/nu15071710
17. Díaz-Tocados, J. M., Lloret, M. J., Domínguez-Coral, J. D., Tinoco Aranda, A. P., Fayos de Arizón, L., Massó Jiménez, E., Bover, J., Valdivielso, J. M., & Rodríguez-Ortiz, M. E. (2025). Magnesium balance in chronic kidney disease: Mineral metabolism, immunosuppressive therapies and sodium-glucose Cotransporter 2 inhibitors. International Journal of Molecular Sciences, 26(12), 5657.
https://doi.org/10.3390/ijms26125657
18. Wang, J., Lin, Y., Chen, X., Li, H., Tang, W., & Zhou, T. (2025). Significance of serum magnesium in parathyroid hormone level in patients with chronic kidney disease. Endocrine, Metabolic & Immune Disorders - Drug Targets, 25(11), 896-904.
https://doi.org/10.2174/0118715303311081241022042321
19. Yonova D. (2020). The impact of magnesium (Mg) on mineral metabolism in diabetic or non-diabetic patients with chronic kidney diseases (CKD). General Internal Medicine and Clinical Innovations, 5(1).
https://doi.org/10.15761/gimci.1000183
20. Xie, J.-Z., Huang, Y., Zheng, X.-F., Feng, R., Li, X.-Y., Zheng, Z.-G., Jiang, B.-J., Du, S., Chen, H.-G., & Xu, Y. (2024). The association between serum magnesium and chronic kidney disease in Chinese adults: a cross-sectional study. BMC Public Health, 24(1).
https://doi.org/10.1186/s12889-023-17615-2
21. Navarro, J. F., Mora, C., Jiménez, A., Torres, A., Macía, M., & García, J. (1999). Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients. American Journal of Kidney Diseases, 34(1), 43-48.
https://doi.org/10.1016/s0272-6386(99)70106-x
22. Wei, M., Esbaei, K., Bargman, J., & Oreopoulos, D. G. (2006). Relationship between serum magnesium, parathyroid hormone, and vascular calcification in patients on dialysis: A literature review. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 26(3), 366-373.
https://doi.org/10.1177/089686080602600315
23. Ohya, M., Negi, S., Sakaguchi, T., Koiwa, F., Ando, R., Komatsu, Y., Shinoda, T., Inaguma, D., Joki, N., Yamaka, T., Ikeda, M., & Shigematsu, T. (2014). Significance of serum magnesium as an independent correlative factor on the parathyroid hormone level in uremic patients. The Journal of Clinical Endocrinology & Metabolism, 99(10), 3873-3878.
https://doi.org/10.1210/jc.2013-4396
24. Abdulaziz, L. M., Saied, H., & Redwan, F. (2022). Relationship between serum magnesium and parathyroid hormone levels in hemodialysis patients. مجلة العلوم الطبية و الصيدلانية, 6(3), 79-87.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
