Low Magnesium Exacerbates Osteoporosis in Chronic Kidney Disease Patients with Diabetes

Table 4

Bone metabolic parameters levels for the CKD patients with osteoporosis by low and high serum Mg levels.

Case	CKD stage	iPTH (pg/mL)	Ca (mg/dL)	P (mg/dL)	25(OH)D (ng/mL)	1,25(OH)2D (pg/mL)	Bone health status
Low serum Mg
Diabetes
1	3	61.3	9.0	3.1	21.6	22.1	Osteoporosis
2	3	26.2	9.4	3.3	37.8	25.9	Osteoporosis
3	4	7.8	9.0	3.1	37.1	35.2	Osteoporosis
4	5	38.1	8.6	4.4	19.9	27.4	Osteoporosis
5	4	24.1	9.7	4.1	32.8	19	Osteopenia
6	3	65.8	8.7	3.6	11.3	5.1	Normal
High serum Mg
Diabetes
1	3	51.5	8.7	3.6	23.8	26.8	Osteoporosis
2	4	83.8	9.0	3.9	13.2	15.9	Osteoporosis
3	5	184.0	8.4	5.9	25.1	19.7	Osteoporosis
4	5	293.0	8.7	4.7	15.9	5.2	Osteoporosis
Nondiabetes
1	5	169.0	8.7	4.2	17.8	3.4	Osteoporosis

(1) For patients with stages 3, 4, and 5 CKD, PTH is in the range of 35–70 pg/mL, 70–110 pg/mL, and 150–300 pg/mL, respectively.
(2) For patients with stages 3 to 4 CKD, serum Ca should be maintained within normal range, 8.9–10.1 mg/dL, and serum P should be within 2.7–4.6 mg/dL. For patients with stage 5 CKD, serum Ca should be 8.4–9.5 mg/dL and serum P target should be 3.3–5.5 mg/dL.
(3) Vitamin D deficiency is defined as a serum 25(OH)D level of less than 20 ng/mL and vitamin D insufficiency is defined as a serum 25(OH)D level of 20 to 30 ng/mL. Serum 1,25(OH)₂D deficiency is defined as a serum 1,25(OH)₂D level of less than 25.1 ng/mL.