Serum magnesium level as a predictor of acute kidney injury in patients with acute pancreatitis

doi:10.12998/wjcc.v9.i35.10899

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World Journal of Clinical Cases

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Dec 16, 2021; 9(35): 10899-10908
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10899

Table 1 Baseline characteristics

	Mg²⁺ (mg/dL)		P value	AKI, n = 85	Non-AKI, n = 148	P value
	< 0.755 mg/dL, n = 87	≥ 0.755 mg/dL, n = 146	P value	AKI, n = 85	Non-AKI, n = 148	P value
Age, yr	39 (32, 52)	44 (34, 58)	0.063	38 (30, 50)	44.5 (35.5, 54.5)	0.011
Gender, male, n (%)	59 (67.8)	98 (67.1)	0.913	59 (69.4)	98 (66.2)	0.913
BMI	27.1 (24.7, 30.1)	25.6 (23.9, 28.1)	0.028	27.6 (24.8, 30.7)	25.4 (23.4, 27.7)	< 0.001
APACHE II	9 (7, 12)	7 (5, 9)	0.002	11 (8, 14)	7 (4, 9)	< 0.001
SOFA	3 (3, 4)	3 (2, 4)	0.075	4 (3, 5)	3 (2, 4)	< 0.001
CTSI	6 (3, 6)	5 (3, 6)	0.122	6 (6, 6)	4 (2, 6)	< 0.001
Severity classification, n (%)			0.064			< 0.001
MAP	21 (24.1)	50 (34.2)		7 (8.2)	64 (43.2)
MSAP	47 (54.0)	79 (54.1)		45 (53.0)	81 (54.7)
SAP	19 (21.8)	17 (11.6)		33 (38.8)	3 (2.1)
Comorbidities
Diabetes	23 (26.4)	24 (16.4)	0.066	20 (23.5)	27 (18.2)	0.066
Hypertension	22 (25.3)	36 (24.7)	0.914	22 (25.9)	36 (24.3)	0.914
Hyperlipidemia	25 (28.7)	36 (24.7)	0.493	21 (24.7)	40 (27.0)	0.493
Laboratory data
WBC	13.4 (10.6, 16.6)	12.8 (10.1, 15.7)	0.336	12.9 (10.9, 16.6)	12.9 (10.3, 16.1)	0.685
Ly%	8.1 (5.1, 11.2)	6.7 (4.7, 10.6)	0.297	6.9 (4.9, 10.5)	7.2 (5, 11.2)	0.769
IL-6	199.6 (104.8, 366.4)	115.4 (45.4, 201.5)	< 0.001	222.8 (130.4, 370)	104.8 (45.4, 178.4)	< 0.001
PCT	1.2 (0.4, 3.3)	0.4 (0.1, 1.6)	< 0.001	2.1 (1.1, 7.7)	0.3 (0.1, 0.8)	< 0.001
Platelets	193 (142, 238)	174 (134, 224)	0.215	199 (132, 236)	176.5 (142, 218)	0.248
BUN	5.4 (3.7, 6.3)	5.1 (4, 6.9)	0.576	6 (4, 8.3)	4.8 (3.8, 5.9)	< 0.001
Creatinine	61 (49, 8)	63 (53, 8)	0.924	50 (41, 57.3)	51 (46, 59)	0.184
HCO^3-	18.9 (15.1, 23.5)	22 (18.7, 24.2)	< 0.001	17.8 (13.7, 21.3)	22.6 (19.8, 24.7)	< 0.001
Cl^-	103 (99, 105)	102 (100, 105)	0.825	103.7 (101, 107)	102 (99, 104)	< 0.001
Mg^2-				0.7 (0.6, 0.7)	0.885 (0.8, 0.9)	< 0.001

Mg²⁺: Magnesium; BMI: Body mass index; AKI: Acute kidney injury; SOFA: Sequential organ failure assessment; CTSI: CT severity index; MAP: Mild acute pancreatitis; MSAP: Mild severe acute pancreatitis; SAP: Severe acute pancreatitis; WBC: White blood cells; Ly%: Lymphocytes%; IL-6: Interleukin-6; PCT: Procalcitonin; BUN: Blood urea nitrogen.

Table 2 Influence of low serum magnesium on clinical course

	Mg²⁺ (mg/dL)		P value
	< 0.755 mg/dL, n = 87	≥ 0.755 mg/dL, n = 146	P value
Primary outcome, n (%)
AKI	54 (62.1)	31 (21.2)	< 0.001
Clinical course, days median
ICU days	3 (2, 6)	2 (1, 4)	< 0.001
Hospital days	6 (4, 10)	4 (3, 7)	< 0.001
Severe outcome, n (%)
ICU mortality	1 (1.15)	3 (2.05)	0.999
30 d mortality	1 (1.15)	3 (2.05)	0.999

Mg²⁺: Magnesium; AKI: Acute kidney injury; ICU: Intensive care unit.

Table 3 Univariate predictors and multivariate model for acute kidney injury occurrence

Univariate analysis	OR	95%CI	P value	Multivariate model	OR	95%CI	P value
Mg²⁺< 0.755, mg/dL	6.070	(3.374, 10.921)	< 0.001	Mg²⁺< 0.755, mg/dL	5.525	(2.074, 14.718)	< 0.001
Age	0.981	(0.963, 1.000)	0.052	Age	0.966	(0.926, 1.007)	0.104
Gender	1.158	(0.652, 2.054)	0.617
BMI	1.155	(1.073, 1.244)	< 0.001	BMI	1.081	(0.946, 1.236)	0.251
APACHE II	1.385	(1.256, 1.527)	< 0.001	APACHE II	1.130	(0.976, 1.310)	0.103
SOFA	1.589	(1.307, 1.931)	< 0.001	SOFA	0.896	(0.604, 1.330)	0.585
CTSI	1.479	(1.279, 1.711)	< 0.001	CTSI	1.107	(0.815, 1.505)	0.516
Severity classification (MAP as reference)				Severity classification (MAP as reference)
MSAP	4.870	(2.071, 11.450)	< 0.001	MSAP	1.126	(0.240, 5.289)	0.880
SAP	84.857	(23.269, 309.458)	< 0.001	SAP	15.260	(1.817, 128.189)	0.012
Diabetes	1.379	(0.718, 2.647)	0.334
Hypertension	1.086	(0.588, 2.007)	0.791
Hyperlipidemia	0.886	(0.480, 1.634)	0.698
WBC	1.026	(0.970, 1.086)	0.910
Ly	0.734	(0.938, 1.046)	0.734
IL-6	1.006	(1.004, 1.009)	< 0.001	IL-6	1.003	(0.999, 1.006)	0.113
PCT	1.350	(1.166, 1.562)	< 0.001	PCT	1.109	(0.959, 1.283)	0.163
Platelets	1.003	(0.999, 1.007)	0.139
BUN	1.368	(1.196, 1.565)	< 0.001	BUN	1.102	(0.826, 1.470)	0.508
Creatinine	1.051	(1.034, 1.069)	< 0.001	Creatinine	1.052	(1.014, 1.091)	0.006
HCO^3-	0.843	(0.794, 0.896)	< 0.001	HCO^3-	0.993	(0.894, 1.103)	0.892
Cl^-	1.100	(1.032, 1.172)	0.003	Cl^-	1.042	(0.936, 1.160)	0.453

Mg²⁺: Magnesium; BMI: Body mass index; AKI: Acute kidney injury; SOFA: Sequential organ failure assessment; CTSI: CT severity index; MAP: Mild acute pancreatitis; MSAP: Mild severe acute pancreatitis; SAP: Severe acute pancreatitis; WBC: White blood cells; IL-6: Interleukin-6; PCT: Procalcitonin; BUN: Blood urea nitrogen; OR: Odds ratio; CI: Confidence interval.

Citation: Yu XQ, Deng HB, Liu Y, Qu C, Duan ZH, Tong ZH, Liu YX, Li WQ. Serum magnesium level as a predictor of acute kidney injury in patients with acute pancreatitis. World J Clin Cases 2021; 9(35): 10899-10908
URL: https://www.wjgnet.com/2307-8960/full/v9/i35/10899.htm
DOI: https://dx.doi.org/10.12998/wjcc.v9.i35.10899