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Abstract
It has been suggested that magnesium carbonate (MgCO3) may be an effective and safe
alternative to calcium carbonate in binding phosphorus in dialysis patients. In these
studies, the concentration of magnesium in the dialysate was either very low or zero.
To date, only patients undergoing conventional dialysis have been reported. The primary
purpose of the present study was to determine the fluxes of magnesium using dialysate
magnesium concentrations of 0 mg/dL, 0.6 mg/dL, and 1.8 mg/dL in eight patients undergoing
high-efficiency hemodialysis. The net removal of magnesium was 486 +/- 44 mg, 306
+/- 69 mg, and 56 +/- 50 mg, with the use of dialysate magnesium concentrations of
0 mg/dL, 0.6 mg/dL, and 1.8 mg/dL, respectively (P = 0.001). Plasma magnesium levels
significantly decreased from 3.3 +/- 0.2 mg/dL to 1.6 +/- 0.2 mg/dL and from 3.4 +/-
0.3 mg/dL to 2.1 +/- 0.2 mg/dL during the dialysis sessions using 0 mg/dL and 0.6
mg/dL magnesium dialysates, respectively. Plasma magnesium remained unchanged when
1.8 mg/dL dialysate magnesium was used. A significant independent correlation was
found between the total magnesium removed and both the dialysate concentration used
(P < 0.001) and the predialysis plasma magnesium level (P < 0.001). The measured magnesium
removal exceeded the estimated predialysis extracellular fluid (ECF) magnesium pool
with the use of magnesium-free dialysate. This was not found with dialysate magnesium
concentrations of either 0.6 mg/dL or 1.8 mg/dL. A secondary purpose of the study
was to determine the acute clinical tolerance of the low and magnesium-free dialysates.(ABSTRACT
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