Serum magnesium level as a predictor of acute kidney injury in patients with acute pancreatitis

Abstract

BACKGROUND

Decreased serum magnesium (Mg²⁺) is commonly seen in critically ill patients. Hypomagnesemia is significantly more frequent in patients with severe acute pancreatitis. Acute kidney injury (AKI) in patients with acute pancreatitis (AP) is associated with an extremely high mortality. The association underlying serum Mg²⁺ and AKI in AP has not been elucidated.

AIM

To explore the association between serum Mg²⁺ on admission and AKI in patients with AP.

METHODS

A retrospective observational study was conducted in a cohort of patients (n = 233) with AP without any renal injury before admission to our center from August 2015 to February 2019. Demographic characteristics on admission, severity score, laboratory values and in-hospital mortality were compared between patients with and without AKI.

RESULTS

A total of 233 patients were included for analysis, including 85 with AKI. Compared to patients without AKI, serum Mg²⁺ level was significantly lower in patients with AKI at admission [OR = 6.070, 95%CI: 3.374-10.921, P < 0.001]. Multivariate logistic analysis showed that lower serum Mg²⁺ was an independent risk factor for AKI [OR = 8.47, 95%CI: 3.02-23.72, P < 0.001].

CONCLUSION

Our analysis indicates that serum Mg²⁺ level at admission is independently associated with the development of AKI in patients with AP and may be a potential prognostic factor.

Keywords: Acute pancreatitis; Acute kidney injury; Magnesium (Mg²⁺); Kidney; Predictor of acute kidney injury

Core Tip: Acute kidney injury (AKI) is a serious complication of acute pancreatitis (AP) and is often difficult to predict at an early stage. However, our clinical analysis found that serum Mg²⁺ on admission is a good predictor of the occurrence of AKI in AP patients. Therefore, this may provide a new method for the early prediction of AKI after AP.