KRONİK BÖBREK HASTALIĞI OLAN HİPOMAGNEZEMİLİ HASTALARDA ÜÇ AYLIK MAGNEZYUM REPLASMANININ PRORETİNÜRİ ÜZERİNE ETKİSİ

Öz

Amaç: Kronik böbrek hastalığında (KBH), diabetes mellitus, metabolik sendrom ve hipertansiyon gibi metabolik bozukluklar yaygındır ve hipomagnezeminin bu bozuklukların gelişimine katkıda bulunduğu düşünülmektedir. Düşük serum magnezyum (Mg) düzeyleri, KBH hastalarında artan mortalite ve daha düşük glomerüler filtrasyon hızı (eGFR) ile ilişkilendirilmiştir. Proteinüri de KBH ilerlemesi için bağımsız bir risk faktörüdür ve kontol altına alınması hastalığın progresyonunu yavaşlatabilir. Bu çalışma, hipomagnezemisi olan evre 1-4 KBH hastalarında üç aylık Mg replasman tedavisinin proteinüri üzerindeki etkisini değerlendirmeyi amaçlamaktadır. Yöntem: Toplam 66 evre 1-4 KBH hastası çalışmaya dahil edildi. Serum Mg ve spot idrar protein/kreatinin oranı (PCR) başlangıçta ve üç ay sonra ölçüldü. Hastalar hipomagnezemik (n=25) ve normomagnezemik (n=41) grup olarak sınıflandırıldı. Hipomagnezemik grup, KBH için verilen tedaviye ek olarak, diyetisyen gözetiminde günde 365 mg elementer Mg ve Mg’dan zengin bir diyet alırken, normomagnezemi grubu standart KBH tedavisi aldı. Veriler SPSS kullanılarak analiz edildi; p<0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Normagnesemik grupta serum Mg ve PCR düzeyleri anlamlı bir değişiklik göstermedi (p>0,05). Hipomagnesemik grupta ise serum Mg düzeyleri başlangıç düzeyine kıyasla anlamlı şekilde arttı (p=0,0001) ve PCR düzeyleri ise belirgin şekilde azaldı (p=0,0001). Sonuç: Sonuç olarak, üç aylık Mg replasman tedavisi hipomagnezemik KBH hastalarında proteinüriyi önemli ölçüde azaltmıştır. Bu bulgular, Mg eksikliğinin yalnızca biyokimyasal bir anormallik değil, böbrek hastalığının ilerlemesini etkileyebilecek değiştirilebilir bir risk faktörü olduğunu göstermektedir. Mg takviyesinin uzun vadeli renal, metabolik ve inflamatuar etkilerini doğrulamak için daha geniş prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Hipomagnezemi
• proteinüri
• kronik böbrek hastalığı

Destekleyen Kurum

ÇOMÜ Bilimsel Araştırma Projeleri tarafından TTU-2017-1241 proje numarasıyla desteklenmiştir.

Etik Beyan

Çalışmanın tüm süreçlerinin araştırma ve yayın etiğine uygun olduğunu, etik kurallara ve bilimsel atıf ilkelerine uygun hareket ettiğimi beyan ederim.

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

Öz

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.

Anahtar Kelimeler

• Hypomagnesemia
• proteinuria
• chronic kidney disease

Destekleyen Kurum

Supported by COMU Scientific Research Projects with project number TTU-2017-1241.

Etik Beyan

I declare that all processes of the study are in accordance with research and publication ethics, and that I comply with ethical rules and scientific citation principles.

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