Electrolyte and Acid-Base Disorders in Chronic Kidney Disease and End-Stage Kidney Failure

Blood Purification

Volumn 43, Issue 1-3, 2017, Pages 179-188

  Dhondup, Tsering ^a   Qian, Qi ^a  

^a MAYO CLINIC   (United States)

Author keywords

Acidosis; Chronic kidney disease; Dyskalemia; Dysmagnesemia; Dysnatremia; End stage renal disease; Mineral bone disorder

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; DIPEPTIDYL CARBOXYPEPTIDASE; MAGNESIUM ION; MINERALOCORTICOID ANTAGONIST; PATIROMER; PHOSPHATE; POTASSIUM; SODIUM ZIRCONIUM CYCLOSILICATE;

CHRONIC KIDNEY DISEASE-MINERAL AND BONE DISORDER; CHRONIC KIDNEY FAILURE; ELECTROLYTE DISTURBANCE; END STAGE RENAL DISEASE; HEART ARRHYTHMIA; HEART DEATH; HEMODIALYSIS PATIENT; HOMEOSTASIS; HUMAN; HYPERKALEMIA; HYPOKALEMIA; HYPOMAGNESEMIA; HYPONATREMIA; INSULIN DEFICIENCY; LEUKOCYTOSIS; METABOLIC ACIDOSIS; MORBIDITY; MORTALITY; PARATHYROID HORMONE BLOOD LEVEL; PRIORITY JOURNAL; RECOMMENDED DRUG DOSE; REVIEW; THROMBOCYTOSIS; VITAMIN D DEFICIENCY; ACID BASE BALANCE; ELECTROLYTE BALANCE; KIDNEY FAILURE, CHRONIC; PATHOPHYSIOLOGY; PHYSIOLOGY; RENAL INSUFFICIENCY, CHRONIC;

ACID-BASE EQUILIBRIUM; HOMEOSTASIS; HUMANS; KIDNEY FAILURE, CHRONIC; RENAL INSUFFICIENCY, CHRONIC; WATER-ELECTROLYTE BALANCE;

EID: 85010842242     PISSN: 02535068     EISSN: 14219735     Source Type: Journal    
DOI: 10.1159/000452725     Document Type: Review

References (132)

1. United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, National Institutes of Health, 2015. www.usrds.org/2015/view/Default.aspx (cited October 8, 2016).
2. De Nicola L, Zoccali C: Chronic kidney disease prevalence in the general population: heterogeneity and concerns. Nephrol Dial Transplant 2016;31:331-335.
3. Luo J, et al. Association between serum potassium and outcomes in patients with reduced kidney function. Clin J Am Soc Nephrol 2016;11:90-100.
4. Sarafidis PA, et al. Prevalence and factors associated with hyperkalemia in predialysis patients followed in a low-clearance clinic. Clin J Am Soc Nephrol 2012;7:1234-1241.
5. Einhorn LM, et al. The frequency of hyperkalemia and its significance in chronic kidney disease. Arch Intern Med 2009;169:1156-1162.
6. Chang AR, et al. Antihypertensive medications and the prevalence of hyperkalemia in a large health system. Hypertension 2016;67:1181-1188.
7. Ingelfinger JR: A new era for the treatment of hyperkalemia? N Engl J Med 2015;372:275-277.
8. Meng QH, Wagar EA: Pseudohyperkalemia: a new twist on an old phenomenon. Crit Rev Clin Lab Sci 2015;52:45-55.
9. Parham WA, et al. Hyperkalemia revisited. Tex Heart Inst J 2006;33:40-47.
10. Khattak HK, et al. Recurrent life-threatening hyperkalemia without typical electrocardiographic changes. J Electrocardiol 2014;47:95-97.
11. Barold SS, Herweg B: The effect of hyperkalaemia on cardiac rhythm devices. Europace 2014;16:467-476.
12. Epstein M, et al. Evaluation of the treatment gap between clinical guidelines and the utilization of renin-angiotensin-aldosterone system inhibitors. Am J Manag Care 2015;21(11 suppl):S212-S220. 26619183
13. Evans BM, et al. Ion-exchange resins in the treatment of anuria. Lancet 1953;265:791-795.
14. Lepage L, et al. Randomized clinical trial of sodium polystyrene sulfonate for the treatment of mild hyperkalemia in CKD. Clin J Am Soc Nephrol 2015;10:2136-2142.
15. Harel Z, et al. Gastrointestinal adverse events with sodium polystyrene sulfonate (Kayexalate) use: a systematic review. Am J Med 2013;126:264.e9-e24.
16. Li L, et al. Mechanism of action and pharmacology of patiromer, a nonabsorbed cross-linked polymer that lowers serum potassium concentration in patients with hyperkalemia. J Cardiovasc Pharmacol Ther 2016;21:456-465.
17. Weir MR, et al. Patiromer in patients with kidney disease and hyperkalemia receiving RAAS inhibitors. N Engl J Med 2015;372:211-221.
18. Bakris GL, et al. Effect of patiromer on serum potassium level in patients with hyperkalemia and diabetic kidney disease: the AMETHYST-DN randomized clinical trial. JAMA 2015;314:151-161.
19. Weir MR, et al. Treatment with patiromer decreases aldosterone in patients with chronic kidney disease and hyperkalemia on renin-angiotensin system inhibitors. Kidney Int 2016;90:696-704.
20. Gekle M, Grossmann C: Actions of aldosterone in the cardiovascular system: the good, the bad, and the ugly? Pflugers Arch 2009;458:231-246.
21. Ritz E, Tomaschitz A: Aldosterone, a vasculotoxic agent-novel functions for an old hormone. Nephrol Dial Transplant 2009;24:2302-2305.
22. Bushinsky DA, et al. Effect of patiromer on urinary ion excretion in healthy adults. Clin J Am Soc Nephrol 2016;pii:CJN.01170216.
23. Packham DK, et al. Sodium zirconium cyclosilicate in hyperkalemia. N Engl J Med 2015;372:222-231.
24. Kosiborod M, et al. Effect of sodium zirconium cyclosilicate on potassium lowering for 28 days among outpatients with hyperkalemia: the HARMONIZE randomized clinical trial. JAMA 2014;312:2223-2233.
25. Bushinsky DA: National Kidney Foundation 2016 Spring Clinical Meetings Abstracts April 27-May 1, 2016. Patiromer Decreases Serum Potassium in Patients on HD. Am J Kidney Dis 2016;67:A1-A118.
26. Adrogué HJ, Madias NE: Sodium and potassium in the pathogenesis of hypertension. N Engl J Med 2007;356:1966-1978.
27. Tobian L, et al. Potassium reduces cerebral hemorrhage and death rate in hypertensive rats, even when blood pressure is not lowered. Hypertension 1985;7(3 pt 2):I110-I114.
28. Chiu DY, et al. Sudden cardiac death in haemodialysis patients: preventative options. Nephrology (Carlton) 2014;19:740-749.
29. Collins AJ, et al. US Renal Data System 2013 Annual Data Report. Am J Kidney Dis 2014;63(1 suppl):A7.
30. Ohtake T, et al. High prevalence of occult coronary artery stenosis in patients with chronic kidney disease at the initiation of renal replacement therapy: an angiographic examination. J Am Soc Nephrol 2005;16:1141-1148.
31. Buiten MS, et al. The dialysis procedure as a trigger for atrial fibrillation: new insights in the development of atrial fibrillation in dialysis patients. Heart 2014;100:685-690.
32. Pun PH, et al. Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. Kidney Int 2011;79:218-227.
33. Jadoul M, et al. Modifiable practices associated with sudden death among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study. Clin J Am Soc Nephrol 2012;7:765-774.
34. Foley RN, et al. Long interdialytic interval and mortality among patients receiving hemodialysis. N Engl J Med 2011;365:1099-1107.
35. Bleyer AJ, et al. Characteristics of sudden death in hemodialysis patients. Kidney Int 2006;69:2268-2273.
36. Bleyer AJ, Russell GB, Satko SG: Sudden and cardiac death rates in hemodialysis patients. Kidney Int 1999;55:1553-1559.
37. Santoro A, et al. Patients with complex arrhythmias during and after haemodialysis suffer from different regimens of potassium removal. Nephrol Dial Transplant 2008;23:1415-1421.
38. Vallet M, et al. Urinary ammonia and long-term outcomes in chronic kidney disease. Kidney Int 2015;88:137-145.
39. Wrong O, Davies HE: The excretion of acid in renal disease. Q J Med 1959;28:259-313.
40. Kim HY, et al. Effect of reduced renal mass on renal ammonia transporter family, Rh C glycoprotein and Rh B glycoprotein, expression. Am J Physiol Renal Physiol 2007;293:F1238-F1247.
41. Karim Z, Attmane-Elakeb A, Bichara M: Renal handling of NH4+ in relation to the control of acid-base balance by the kidney. J Nephrol 2002;15(suppl 5):S128-S134.
42. Nath KA, Hostetter MK, Hostetter TH: Pathophysiology of chronic tubulo-interstitial disease in rats. Interactions of dietary acid load, ammonia, and complement component C3. J Clin Invest 1985;76:667-675.
43. Wesson DE, Simoni J: Acid retention during kidney failure induces endothelin and aldosterone production which lead to progressive GFR decline, a situation ameliorated by alkali diet. Kidney Int 2010;78:1128-1135.
44. Wesson DE, et al. Acid retention accompanies reduced GFR in humans and increases plasma levels of endothelin and aldosterone. Am J Physiol Renal Physiol 2011;300:F830-F837.
45. Shah SN, et al. Serum bicarbonate levels and the progression of kidney disease: a cohort study. Am J Kidney Dis 2009;54:270-277.
46. Raphael KL, et al. Higher serum bicarbonate levels within the normal range are associated with better survival and renal outcomes in African Americans. Kidney Int 2011;79:356-362.
47. Kanda E, et al. High serum bicarbonate level within the normal range prevents the progression of chronic kidney disease in elderly chronic kidney disease patients. BMC Nephrol 2013;14:4.
48. Raphael KL, et al. Prevalence of and risk factors for reduced serum bicarbonate in chronic kidney disease. Nephrology (Carlton) 2014;19:648-654.
49. Kopple JD, Kalantar-Zadeh K, Mehrotra R: Risks of chronic metabolic acidosis in patients with chronic kidney disease. Kidney Int Suppl 2005;95:S21-S27.
50. Kraut JA, Kurtz I: Metabolic acidosis of CKD: diagnosis, clinical characteristics, and treatment. Am J Kidney Dis 2005;45:978-993.
51. Kovesdy CP, Anderson JE, Kalantar-Zadeh K: Association of serum bicarbonate levels with mortality in patients with non-dialysis-dependent CKD. Nephrol Dial Transplant 2009;24:1232-1237.
52. Driver TH, et al. Low serum bicarbonate and kidney function decline: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Kidney Dis 2014;64:534-541.
53. de Brito-Ashurst I, et al. Bicarbonate supplementation slows progression of CKD and improves nutritional status. J Am Soc Nephrol 2009;20:2075-2084.
54. Mahajan A, et al. Daily oral sodium bicarbonate preserves glomerular filtration rate by slowing its decline in early hypertensive nephropathy. Kidney Int 2010;78:303-309.
55. Phisitkul S, et al. Amelioration of metabolic acidosis in patients with low GFR reduced kidney endothelin production and kidney injury, and better preserved GFR. Kidney Int 2010;77:617-623.
56. Abramowitz MK, et al. Effects of oral sodium bicarbonate in patients with CKD. Clin J Am Soc Nephrol 2013;8:714-720.
57. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2013;(suppl):73.
58. Goraya N, et al. Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rate. Kidney Int 2014;86:1031-1038.
59. Dobre M, et al. Persistent high serum bicarbonate and the risk of heart failure in patients with chronic kidney disease (CKD): a report from the Chronic Renal Insufficiency Cohort (CRIC) study. J Am Heart Assoc 2015;4:pii:e001599.
60. Witham MD, et al. Does oral sodium bicarbonate therapy improve function and quality of life in older patients with chronic kidney disease and low-grade acidosis (the BiCARB trial)? Study protocol for a randomized controlled trial. Trials 2015;16:326.
61. Gaggl M, et al. Effect of oral sodium bicarbonate supplementation on progression of chronic kidney disease in patients with chronic metabolic acidosis: study protocol for a randomized controlled trial (SoBic-Study). Trials 2013;14:196.
62. Di Iorio B, et al. A prospective, multicenter, randomized, controlled study: the correction of metabolic acidosis with use of bicarbonate in Chronic Renal Insufficiency (UBI) Study. J Nephrol 2012;25:437-440.
63. Tentori F, et al. Association of dialysate bicarbonate concentration with mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 2013;62:738-746.
64. Moe S, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2006;69:1945-1953.
65. Levin A, et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int 2007;71:31-38.
66. Tejwani V, Qian Q: Calcium regulation and bone mineral metabolism in elderly patients with chronic kidney disease. Nutrients 2013;5:1913-1936.
67. Moranne O, et al. Timing of onset of CKD-related metabolic complications. J Am Soc Nephrol 2009;20:164-171.
68. Reynolds JL, et al. Human vascular smooth muscle cells undergo vesicle-mediated calcification in response to changes in extracellular calcium and phosphate concentrations: a potential mechanism for accelerated vascular calcification in ESRD. J Am Soc Nephrol 2004;15:2857-2867.
69. Mathew S, et al. The mechanism of phosphorus as a cardiovascular risk factor in CKD. J Am Soc Nephrol 2008;19:1092-1105.
70. Chen NX, Moe SM: Pathophysiology of vascular calcification. Curr Osteoporos Rep 2015;13:372-380.
71. Goodman WG, et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000;342:1478-1483.
72. O'Seaghdha CM, et al. Serum phosphorus predicts incident chronic kidney disease and end-stage renal disease. Nephrol Dial Transplant 2011;26:2885-2890.
73. Kestenbaum B, et al. Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol 2005;16:520-528.
74. Chartsrisak K, et al. Mineral metabolism and outcomes in chronic kidney disease stage 2-4 patients. BMC Nephrol 2013;14:14.
75. Jung SY, et al. Electrolyte and mineral disturbances in septic acute kidney injury patients undergoing continuous renal replacement therapy. Medicine (Baltimore) 2016;95:e4542.
76. Da J, et al. Serum phosphorus and progression of CKD and mortality: a meta-analysis of cohort studies. Am J Kidney Dis 2015;66:258-265.
77. Dhingra R, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med 2007;167:879-885.
78. Tonelli M, Pfeffer MA: Kidney disease and cardiovascular risk. Annu Rev Med 2007;58:123-139.
79. Larsson TE, et al. Conjoint effects of serum calcium and phosphate on risk of total, cardiovascular, and noncardiovascular mortality in the community. Arterioscler Thromb Vasc Biol 2010;30:333-339.
80. Gutierrez OM, et al. Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N Engl J Med 2008;359:584-592.
81. Noordzij M, et al. Mineral metabolism and mortality in dialysis patients: a reassessment of the K/DOQI guideline. Blood Purif 2008;26:231-237.
82. Lee SK, Lorenzo JA: Parathyroid hormone stimulates TRANCE and inhibits osteoprotegerin messenger ribonucleic acid expression in murine bone marrow cultures: correlation with osteoclast-like cell formation. Endocrinology 1999;140:3552-3561.
83. Armbrecht HJ, et al. Induction of the vitamin D 24-hydroxylase (CYP24) by 1, 25-dihydroxyvitamin D3 is regulated by parathyroid hormone in UMR106 osteoblastic cells. Endocrinology 1998;139:3375-3381.
84. Shinki T, et al. Parathyroid hormone inhibits 25-hydroxyvitamin D3-24-hydroxylase mRNA expression stimulated by 1 alpha, 25-dihydroxyvitamin D3 in rat kidney but not in intestine. J Biol Chem 1992;267:13757-13762.
85. Brenza HL, DeLuca HF: Regulation of 25-hydroxyvitamin D3 1alpha-hydroxylase gene expression by parathyroid hormone and 1, 25-dihydroxyvitamin D3. Arch Biochem Biophys 2000;381:143-152.
86. Jeong HS, Dominguez AR: Calciphylaxis: controversies in pathogenesis, diagnosis and treatment. Am J Med Sci 2016;351:217-227.
87. Holick MF: Vitamin D deficiency. N Engl J Med 2007;357:266-281.
88. Liu WC, et al. Pleiotropic effects of vitamin D in chronic kidney disease. Clin Chim Acta 2016;453:1-12.
89. Pilz S, et al. Vitamin D status and mortality risk in CKD: a meta-analysis of prospective studies. Am J Kidney Dis 2011;58:374-382.
90. Schottker B, et al. Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States. BMJ 2014;348:G3656.
91. Cheng Z, Lin J, Qian Q: Role of vitamin D in cognitive function in chronic kidney disease. Nutrients 2016;8:pii:E291.
92. Mehrotra R, et al. Hypovitaminosis D in chronic kidney disease. Clin J Am Soc Nephrol 2008;3:1144-1151.
93. Andrukhova O, et al. FGF23 acts directly on renal proximal tubules to induce phosphaturia through activation of the ERK1/2-SGK1 signaling pathway. Bone 2012;51:621-628.
94. Prie D, Friedlander G: Reciprocal control of 1, 25-dihydroxyvitamin D and FGF23 formation involving the FGF23/Klotho system. Clin J Am Soc Nephrol 2010;5:1717-1722.
95. Krajisnik T, et al. Fibroblast growth factor-23 regulates parathyroid hormone and 1alpha-hydroxylase expression in cultured bovine parathyroid cells. J Endocrinol 2007;195:125-131.
96. Koizumi M, Komaba H, Fukagawa M: Parathyroid function in chronic kidney disease: role of FGF23-Klotho axis. Contrib Nephrol 2013;180:110-123.
97. Isakova T, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int 2011;79:1370-1378.
98. Scialla JJ, et al. Fibroblast growth factor-23 and cardiovascular events in CKD. J Am Soc Nephrol 2014;25:349-360.
99. Faul C, et al. FGF23 induces left ventricular hypertrophy. J Clin Invest 2011;121:4393-4408.
100. Fliser D, et al. Fibroblast growth factor 23 (FGF23) predicts progression of chronic kidney disease: the Mild to Moderate Kidney Disease (MMKD) Study. J Am Soc Nephrol 2007;18:2600-2608.
101. Isakova T, et al. Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA 2011;305:2432-2439.
102. Jamal SA, et al. Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Lancet 2013;382:1268-1277.
103. Sekercioglu N, et al. Comparative effectiveness of phosphate binders in patients with chronic kidney disease: a systematic review and network meta-analysis. PLoS One 2016;11:e0156891.
104. Patel L, Bernard LM, Elder GJ: Sevelamer versus calcium-based binders for treatment of hyperphosphatemia in CKD: a meta-analysis of randomized controlled trials. Clin J Am Soc Nephrol 2016;11:232-244.
105. de Francisco AL, et al. Evaluation of calcium acetate/magnesium carbonate as a phosphate binder compared with sevelamer hydrochloride in haemodialysis patients: a controlled randomized study (CALMAG study) assessing efficacy and tolerability. Nephrol Dial Transplant 2010;25:3707-3717.
106. Covic A, et al. A comparison of calcium acetate/magnesium carbonate and sevelamer-hydrochloride effects on fibroblast growth factor-23 and bone markers: post hoc evaluation from a controlled, randomized study. Nephrol Dial Transplant 2013;28:2383-2392.
107. De Schutter TM, et al. Effect of a magnesium-based phosphate binder on medial calcification in a rat model of uremia. Kidney Int 2013;83:1109-1117.
108. Neven E, et al. A magnesium based phosphate binder reduces vascular calcification without affecting bone in chronic renal failure rats. PLoS One 2014;9:e107067.
109. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group: KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl 2009;113:S1-S130.
110. Miskulin DC, et al. Ergocalciferol supplementation in hemodialysis patients with vitamin D deficiency: a randomized clinical trial. J Am Soc Nephrol 2016;27:1801-1810.
111. Perez-Ricart A, et al. Effectiveness of cinacalcet in patients with chronic kidney disease and secondary hyperparathyroidism not receiving dialysis. PLoS One 2016;11:e0161527.
112. Tominaga Y, et al. Parathyroidectomy for secondary hyperparathyroidism in the era of calcimimetics. Ther Apher Dial 2008;12(suppl 1):S21-S26.
113. Blagodatski A, Poteryaev D, Katanaev VL: Targeting the Wnt pathways for therapies. Mol Cell Ther 2014;2:28.
114. Carrillo-Lopez N, et al. Direct inhibition of osteoblastic Wnt pathway by fibroblast growth factor 23 contributes to bone loss in chronic kidney disease. Kidney Int 2016;90:77-89.
115. Frenkel WN, et al. The association between serum sodium levels at time of admission and mortality and morbidity in acutely admitted elderly patients: a prospective cohort study. J Am Geriatr Soc 2010;58:2227-2228.
116. Holland-Bill L, et al. Hyponatremia and mortality risk: a Danish cohort study of 279/508 acutely hospitalized patients. Eur J Endocrinol 2015;173:71-81.
117. Liamis G, et al. Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med 2013;126:256-263.
118. Miller M, Morley JE, Rubenstein LZ: Hyponatremia in a nursing home population. J Am Geriatr Soc 1995;43:1410-1413.
119. Olsson K, Ohlin B, Melander O: Epidemiology and characteristics of hyponatremia in the emergency department. Eur J Intern Med 2013;24:110-116.
120. Zilberberg MD, et al. Epidemiology, clinical and economic outcomes of admission hyponatremia among hospitalized patients. Curr Med Res Opin 2008;24:1601-1608.
121. Palevsky PM, Bhagrath R, Greenberg A: Hypernatremia in hospitalized patients. Ann Intern Med 1996;124:197-203.
122. Zhang YZ, Qie JY, Zhang QH: Incidence and mortality prognosis of dysnatremias in neurologic critically ill patients. Eur Neurol 2015;73:29-36.
123. Kovesdy CP, et al. Hyponatremia, hypernatremia, and mortality in patients with chronic kidney disease with and without congestive heart failure. Circulation 2012;125:677-684.
124. Corona G, et al. Hyponatremia improvement is associated with a reduced risk of mortality: evidence from a meta-analysis. PLoS One 2015;10:e0124105.
125. Berl T: Impact of solute intake on urine flow and water excretion. J Am Soc Nephrol 2008;19:1076-1078.
126. Adrogue HJ, Madias NE: Hypernatremia. N Engl J Med 2000;342:1493-1499.
127. Huang H, et al. Associations of dysnatremias with mortality in chronic kidney disease. Nephrol Dial Transplant 2016;pii:gfw209.
128. Ravel VA, et al. Serum sodium and mortality in a national peritoneal dialysis cohort. Nephrol Dial Transplant 2016;pii:gfw254.
129. Rhee CM, et al. Pre-dialysis serum sodium and mortality in a national incident hemodialysis cohort. Nephrol Dial Transplant 2016;31:992-1001.
130. Cheungpasitporn W, Thongprayoon C, Qian Q: Dysmagnesemia in hospitalized patients: prevalence and prognostic importance. Mayo Clin Proc 2015;90:1001-1010.
131. Sakaguchi Y, et al. Hypomagnesemia is a significant predictor of cardiovascular and non-cardiovascular mortality in patients undergoing hemodialysis. Kidney Int 2014;85:174-181.
132. Yang X, et al. Serum magnesium levels and hospitalization and mortality in incident peritoneal dialysis patients: a cohort study. Am J Kidney Dis 2016;68:619-627.