Increased serum magnesium levels in hemodialysis patients might worsen dyslipemia.

What is it about?

Hyperlipidemia is a serious metabolic disorder which may promote early development of cardiovascular disease. Abnormalities in lipid and/or protein content of lipoprotein have been described in patients with chronic renal failure.This was initially recognized as hypertriglyceridemia without an increase in total cholesterol. The specific characteristics of lipid abnormalities have been further defined; an increase was demonstrated in VLDL, IDL and LDL, whereas HDL-cholesterol has generally found to be decreased. Magnesium retention is also a problem in patients on maintenance hemodialysis: the majority of dialysis patients present hypermagnesemia. Magnesium deficiency has a possible role in the perturbation of lipid metabolism in the non-uremic population.6 Furthermore, it has been shown that in uremic rats magnesium deficiency worsens several serum-lipids parameters.

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Why is it important?

At first sight our data seem to contradict accumulated experience, but there are conflicting data on cholesterol in man and experimental rat. Whereas in uremic patients HDL-C are commonly reduced, in contrast, in uremic rats elevated total cholesterol and HDL-C levels have been observed. Moreover, while most cholesterol appears to be transported in HDL in rats; in man, low-density lipoprotein appears to be the principal class involved in the transport of plasma cholesterol.Experimentally Mg does not seem to increase lipoprotein synthesis but to be involved in the regulation of cholesterol ester hydrolases, which promote the mobilization of this esters. Therefore, if magnesium can induce an increase in HDL-C in rats, it could be expected to induce an increase in LDL-C in man, as our results showed.

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