Title: Renoprotective Effects of Oral Magnesium Supplementation among Hypomagnesemic Type 2 Diabetes Mellitus Nephropathy
Authors: Sagnika Tripathy, Butungeshwar Pradhan, Tejeshwar Reddy P
Background: Insulin resistance or deficiency and hyperglycemic osmotic diuresis increase urinary loss of magnesium. Both intracellular and extracellular magnesium deficiency may lead to early progression of diabetic nephropathy to end stage renal disease (ESRD). Benefit of oral magnesium supplementation on metabolic profiles of diabetes has been reported in some studies. Hence, the present study was undertaken to know, whether oral magnesium supplementation in hypomagnesemic T2DM nephropathy decreases proteinuria and delay the progression to ESRD.
Methods: Twenty four hour total urinary protein measurement and creatinine clearance measured by Cocroft Gault formula was done at baseline. Magnesium Oxide 400mg twice daily was given orally to 39 patients and 37 were taken as control. Twenty four hour total urinary protein, serum magnesium and creatinine clearance was repeated at ≥ 3month interval at least 3 times during the study period of 24 months. All patients were received standard treatment for confounding conditions and glycemic control. Data were collected and analysed and p value of <0.05 was considered significant.
Results: T2DM patients with proteinuria who received oral magnesium had normalization of their serum magnesium levels and had declined proteinuria and improvement in GFR, in comparison to control group had further decline in serum magnesium levels and progression of proteinuria and faster deterioration of GFR.
Conclusions: Oral magnesium supplementation corrects hypomagnesaemia in patients with T2DM and decreases proteinuria and delay the progression to ESRD.
Keywords: Hypomagnesaemia, Oral Magnesium, Proteinuria, Nephropathy, T2DM.