Supplementary Material for: Impact Of Post-Transplantation Hypomagnesemia On Long-Term Graft And Patient Survival After Transplantation

BACKGROUND: Post-transplant hypomagnesemia is commonly observed among patients prescribed CNIs. METHODS: We conducted a retrospective single center analysis (2000-2013, N=726) to examine the association of hypomagnesemia with long-term patient and allograft outcomes in kidney transplant recipients. A median serum magnesium level of all measured magnesium levels from 1 month to 1 year post-transplant was calculated. RESULTS: For every increase in Mg of 0.1 mg/dL, the risk for either graft loss or death, overall survival and death with a functioning graft increased by 11%, 14% and 12% respectively (p < 0.01). In a multivariate model, patients with median Mg level ≥ 1.7 mg/dL had a reduced overall survival rate (HR 1.57, 95% CI 1.04-2.38, p = 0.033) compared to those with median Mg level < 1.7 mg/dL. This association was observed in subgroups of patients above 60 years old, in those who had a slow graft function (SGF) and in females. CONCLUSIONS: Post-transplant hypomagnesemia is associated with better patient and allograft survival up to 10 years post-transplant. This relationship remained significant after accounting for baseline allograft function, presence of slow graft function (SGF) and CNI trough levels.

【研究背景】移植后低镁血症在接受钙调磷酸酶抑制剂（Calcineurin Inhibitors, CNIs）治疗的患者中较为常见。
【研究方法】本研究为单中心回顾性分析，纳入2000年至2013年间的726例肾移植受者，旨在探讨低镁血症与肾移植受者长期患者生存及移植物结局的关联。研究计算了移植后1个月至1年内所有血清镁检测值的中位数水平。
【研究结果】血清镁浓度每升高0.1 mg/dL，移植物失功或死亡的复合风险、全因死亡风险以及移植物有功能时的死亡风险分别升高11%、14%和12%（p < 0.01）。在多变量模型中，与血清镁中位数水平<1.7 mg/dL的患者相比，血清镁中位数≥1.7 mg/dL的患者总体生存率更低（风险比HR=1.57，95%置信区间CI：1.04~2.38，p=0.033）。该关联在60岁以上患者、移植肾功能延迟恢复（Slow Graft Function, SGF）患者以及女性亚组中均存在。
【研究结论】移植后低镁血症与肾移植术后10年内更佳的患者及移植物生存率相关。在校正基线移植物功能、移植肾功能延迟恢复（SGF）发生情况以及钙调磷酸酶抑制剂谷浓度后，该关联仍具有统计学意义。