Effects of Magnesium Supplementation on Clinical and Biochemical Outcomes in Patients with Chronic Kidney Disease: A Systematic Review of Randomized Controlled Trials

Authors

  • Lisa Rifani RSUD dr. Soedono Madiun
  • Rakhmad Ramadhan RSUD dr. Soedono Madiun

DOI:

https://doi.org/10.59141/-.v8i2.579

Keywords:

chronic kidney disease, magnesium, magnesium supplementation, vascular calcification, randomized controlled trial

Abstract

Chronic kidney disease (CKD) is associated with metabolic and cardiovascular complications, as well as mineral and bone disorders. Hypomagnesemia occurs in some patients with CKD and has been associated with disease progression and increased mortality. Magnesium supplementation may improve various clinical and biochemical outcomes; however, findings across studies remain inconsistent. A systematic literature search was conducted using electronic databases, including PubMed and Embase, to identify randomized controlled trials (RCTs) evaluating oral magnesium supplementation in adults with CKD. The outcomes assessed included vascular parameters, kidney function, metabolic outcomes, mineral and bone metabolism parameters, inflammatory markers, and safety. Ten RCTs met the eligibility criteria, including seven studies involving patients with nondialysis-dependent CKD and three involving patients undergoing hemodialysis. Intervention durations ranged from 8 weeks to 2 years. Magnesium supplementation demonstrated potential benefits for certain vascular outcomes, particularly carotid intima-media thickness (cIMT) and serum calcification propensity, as measured by the T50 test, as well as selected metabolic parameters. However, its effects on coronary artery calcification (CAC) progression, kidney function, mineral and bone metabolism, inflammation, and oxidative stress were inconsistent across studies. No cases of severe symptomatic hypermagnesemia were reported, although gastrointestinal adverse effects, particularly diarrhea, were among the most frequently reported adverse events. Oral magnesium supplementation may provide benefits for selected vascular and metabolic outcomes in patients with CKD. However, the available evidence remains inconsistent and insufficient to support routine magnesium supplementation in all patients with CKD.

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References

Abdel-Hameed, A. R., Ahmed, M. F., Elsantawy, A. A., & Mohammad, M. B. (2022). Prevalence, risk factors and impact of proteinuria-associated hypomagnesemia in chronic kidney disease patients: Cross-sectional study. The Egyptian Journal of Internal Medicine, 34, 25. https://doi.org/10.1186/s43162-021-00083-8

Azem, R., Daou, R., & Bassil, E. (2020). Serum magnesium, mortality and disease progression in chronic kidney disease. BMC Nephrology, 21(1), 49.

Biyik, Z., Yavuz, Y. C., & Altintepe, L. (2020). Association between serum magnesium and anemia in patients with chronic kidney disease. International Urology and Nephrology, 52(10), 1935–1941. https://doi.org/10.1007/s11255-020-02525-8

Bressendorff, I., Hansen, D., Schou, M., et al. (2017). Oral magnesium supplementation in chronic kidney disease stages 3 and 4: Efficacy, safety, and effect on serum calcification propensity. Kidney International Reports, 2(3), 380–389.

Bressendorff, I., Hansen, D., Schou, M., et al. (2023). The effect of magnesium supplementation on vascular calcification in CKD: A randomized clinical trial (MAGiCAL-CKD). Journal of the American Society of Nephrology, 34(5), 886–894.

Cunningham, J., Rodríguez, M., & Messa, P. (2012). Magnesium in chronic kidney disease stages 3 and 4 and in dialysis patients. Clinical Kidney Journal, 5(Suppl. 1), i39–i51.

Halawa, N., Elsaid, T. W., El Wakeel, L. M., & Shawki, M. A. (2023). Impact of magnesium supplementation on clinical outcome and disease progression of patients with diabetic nephropathy. Therapeutic Advances in Chronic Disease, 14, 20406223231214640.

Jahnen-Dechent, W., & Ketteler, M. (2012). Magnesium basics. Clinical Kidney Journal, 5(Suppl. 1), i3–i14.

Mark, P. B., Stafford, L. K., Grams, M. E., Aalruz, H., Abd ElHafeez, S., Abdelgalil, A. A., et al. (2025). Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: A systematic analysis for the Global Burden of Disease Study 2023. The Lancet, 406(10518), 2461–2482. https://doi.org/10.1016/S0140-6736(25)01853-7

Mortazavi, M., Moeinzadeh, F., Saadatnia, M., et al. (2013). Effect of magnesium supplementation on carotid intima-media thickness and flow-mediated dilatation among hemodialysis patients. European Neurology, 69(5), 309–315.

Oka, T., Hamano, T., Sakaguchi, Y., Yamaguchi, S., Kubota, K., Senda, M., Yonemoto, S., Shimada, K., Matsumoto, A., Hashimoto, N., Mori, D., Monden, C., Takahashi, A., Obi, Y., Yamamoto, R., Takabatake, Y., Kaimori, J.-Y., Moriyama, T., Horio, M., . . . Isaka, Y. (2019). Proteinuria-associated renal magnesium wasting leads to hypomagnesemia: A common electrolyte abnormality in chronic kidney disease. Nephrology Dialysis Transplantation, 34(7), 1154–1162. https://doi.org/10.1093/ndt/gfy119

Panta, R., & Regmi, S. (2024). Role of magnesium, effects of hypomagnesemia, and benefits of magnesium supplements in cardiovascular and chronic kidney diseases. Cureus, 16(7), e64404. https://doi.org/10.7759/cureus.64404

Pendón-Ruiz de Mier, M. V., Santamaría, R., Moyano-Peregrín, C., et al. (2024). Bone and vascular effects of magnesium supplements in CKD patients: The MagicalBone pilot study. Nefrología, 44(5), 721–730.

Sadeghian, M., Azadbakht, L., Khalili, N., et al. (2020). Oral magnesium supplementation improved lipid profile but increased insulin resistance in patients with diabetic nephropathy. Biological Trace Element Research, 193(1), 23–35.

Sakaguchi, Y. (2022). The emerging role of magnesium in CKD. Clinical and Experimental Nephrology, 26(5), 379–384. https://doi.org/10.1007/s10157-022-02182-4

Sakaguchi, Y., Hamano, T., Obi, Y., et al. (2019). A randomized trial of magnesium oxide and oral carbon adsorbent for coronary artery calcification in predialysis CKD. Journal of the American Society of Nephrology, 30(6), 1073–1085.

Sakaguchi, Y., Shoji, T., Hayashi, T., et al. (2012). Hypomagnesemia in type 2 diabetic nephropathy: A novel predictor of end-stage renal disease. Diabetes Care, 35(7), 1591–1597.

Shroff, R., Wesseling-Perry, K., & Bacchetta, J. (2022). Chronic kidney disease–mineral and bone disorder (CKD-MBD). In Pediatric Nephrology (pp. 1751–1778). Springer.

Talari, H. R., Zakizade, M., Soleimani, A., Bahmani, F., Ghaderi, A., Mirhosseini, N., et al. (2019). Effects of magnesium supplementation on carotid intima-media thickness and metabolic profiles in diabetic haemodialysis patients: A randomised, double-blind, placebo-controlled trial. British Journal of Nutrition, 121(7), 809–817.

Toprak, O., Kurt, H., Sarı, Y., et al. (2017). Magnesium replacement improves the metabolic profile in obese and pre-diabetic patients with mild-to-moderate chronic kidney disease. Kidney and Blood Pressure Research, 42(1), 33–42.

Turgut, F., Kanbay, M., Metin, M. R., et al. (2008). Magnesium supplementation helps to improve carotid intima media thickness in patients on hemodialysis. International Urology and Nephrology, 40(4), 1075–1082.

Vermeulen, E. A., & Vervloet, M. G. (2023). Magnesium administration in chronic kidney disease. Nutrients, 15(3), 547.

Yin, S., Zhou, Z., Lin, T., & Wang, X. (2023). Magnesium depletion score is associated with long-term mortality in chronic kidney diseases: A prospective population-based cohort study. Journal of Nephrology, 36, 755–765. https://doi.org/10.1007/s40620-022-01489-5

Zhan, Y., Zhang, R., & Li, G. (2023). Effect of magnesium on vascular calcification in chronic kidney disease patients: A systematic review and meta-analysis. Renal Failure, 45(1), 2182603. https://doi.org/10.1080/0886022X.2023.2182603

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Published

2026-11-09

How to Cite

Rifani, L., & Ramadhan , R. (2026). Effects of Magnesium Supplementation on Clinical and Biochemical Outcomes in Patients with Chronic Kidney Disease: A Systematic Review of Randomized Controlled Trials. Jurnal Sehat Indonesia (JUSINDO), 8(2), 975–987. https://doi.org/10.59141/-.v8i2.579