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Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation

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Abstract

Background

Hypomagnesemia is associated with increased peripheral insulin resistance in the general population. It is frequently seen after renal transplantation. We examined its role as a risk factor for new-onset diabetes after transplantation (NODAT) and new-onset pre-diabetes after transplantation (NOPDAT).

Methods

A retrospective analysis of 138 previously non-diabetic renal transplant recipients was conducted. Cox and logistic regression analyses were performed to examine the associations between 1-month post-transplant serum magnesium level and subsequent diagnoses of NODAT/NOPDAT.

Results

NODAT was diagnosed in 34 (24.6 %) and NOPDAT in 12 (8.7 %) patients. Median time to diagnosis of NODAT/NOPDAT was 20.4 months (interquartile range [IQR] 6.8–34.8). Median follow up for the entire group was 3.5 years (IQR 2.3–5.6). Mean magnesium level at 1 month after transplantation was significantly lower in patients subsequently diagnosed with NODAT/NOPDAT (1.60 ± 0.27 vs. 1.76 ± 0.29 mg/dl, p = 0.002). Cox regression analysis identified a trend towards developing NODAT/NOPDAT with lower baseline magnesium levels (hazard ratio 0.89 per 0.1 mg/dl increment in magnesium level, 95 % confidence interval [CI] = 0.78–1.01, p = 0.07); a stronger relationship between the two variables was seen at logistic regression analysis (odds ratio 0.81 per 0.1 mg/dl increment in serum magnesium (95 % CI 0.67–0.98, p = 0.03).

Conclusions

A lower magnesium level at 1 month after transplantation may be predictive of a subsequent diagnosis of glucose intolerance or diabetes in renal transplant recipients. Whether replenishing magnesium stores can prevent development of these disorders requires further investigation.

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Notes

  1. The variables used in the models include magnesium level at 1 month after transplantation, age, family history of diabetes, race, presence of post transplantation hyperglycemia, body mass index (BMI), and recipient hepatitis C and cytomegalovirus (CMV) status.

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Conflict of interest

On behalf of all the authors, the corresponding author states there is no conflict of interest.

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Authors and Affiliations

  1. Department of Internal Medicine, Boston University Medical Center, Boston, MA, 02118, USA

    Neetika Garg

  2. Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA

    Janice Weinberg

  3. Renal Section, Department of Medicine, Boston University, Boston, MA, 02118, USA

    Sandeep Ghai, Gitana Bradauskaite, Jean Francis & Joline L. T. Chen

  4. Department of Transplant Surgery, Boston University Medical Center, Boston, MA, 02118, USA

    Matthew Nuhn & Amitabh Gautam

  5. Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, 02139, USA

    Nilay Kumar

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  1. Neetika Garg
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  2. Janice Weinberg
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  3. Sandeep Ghai
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  4. Gitana Bradauskaite
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Correspondence to Neetika Garg.

Additional information

Dr. J. Francis and Dr. J. L. T. Chen shared the responsibilities of last author.

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Garg, N., Weinberg, J., Ghai, S. et al. Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation. J Nephrol 27, 339–344 (2014). https://doi.org/10.1007/s40620-014-0072-1

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  • DOI: https://doi.org/10.1007/s40620-014-0072-1

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