Association of Serum Magnesium and Phosphorus with Vascular Calcification and Cardiovascular Events in Hemodialysis Patients

Zhiwei WEI; Chunming JIANG; Wei ZHOU; Bai ZHA

doi:10.12259/j.issn.2095-610X.S20251009

Volume 46 Issue 10

Oct. 2025

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Zhiwei WEI, Chunming JIANG, Wei ZHOU, Bai ZHA. Association of Serum Magnesium and Phosphorus with Vascular Calcification and Cardiovascular Events in Hemodialysis Patients[J]. Journal of Kunming Medical University, 2025, 46(10): 77-84. doi: 10.12259/j.issn.2095-610X.S20251009

Citation:

Zhiwei WEI, Chunming JIANG, Wei ZHOU, Bai ZHA. Association of Serum Magnesium and Phosphorus with Vascular Calcification and Cardiovascular Events in Hemodialysis Patients[J]. Journal of Kunming Medical University, 2025, 46(10): 77-84. doi: 10.12259/j.issn.2095-610X.S20251009

Citation:

Zhiwei WEI, Chunming JIANG, Wei ZHOU, Bai ZHA. Association of Serum Magnesium and Phosphorus with Vascular Calcification and Cardiovascular Events in Hemodialysis Patients[J]. Journal of Kunming Medical University, 2025, 46(10): 77-84. doi: 10.12259/j.issn.2095-610X.S20251009

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Association of Serum Magnesium and Phosphorus with Vascular Calcification and Cardiovascular Events in Hemodialysis Patients

doi: 10.12259/j.issn.2095-610X.S20251009

Zhiwei WEI^{1, 2
,},
Chunming JIANG^{1
,
,},
Wei ZHOU²,
Bai ZHA²

1.
Department of Nephrology，Drum Tower Clinical Medical College of Nanjing Medical University，Nanjing Jiangsu 210003
2.
Department of Nephrology，Gaochun People’s Hospital of Nanjing/Gaochun Hospital Affiliated to Jiangsu University，Nanjing Jiangsu 211300，China

Received Date: 2025-07-17
Available Online: 2025-10-09
Publish Date: 2025-10-28

Abstract

Abstract

Objective To investigate the association between serum magnesium levels, serum phosphorus concentrations, vascular calcification, and cardiovascular disease mortality in maintenance hemodialysis patients. Methods This study enrolled 200 hemodialysis patients admitted to Nanjing Drum Tower Hospital from May 2020 to May 2022 as subjects, with an additional 200 healthy individuals from the same period selected as a control group. The biochemical indicators between the two groups were compared; their correlations were analyzed. Binary logistic regression was used to investigate the independent factors of serum magnesium and phosphorus levels in relation to vascular calcification and cardiovascular events in maintenance hemodialysis patients. ROC curve analysis was employed to assess the predictive value of serum magnesium and phosphorus for vascular calcification and cardiovascular events. Results The research group's patients exhibited significantly elevated levels of blood phosphorus, calcium-phosphorus product, iPTH, AACS, and 25-（OH）-VitD compared to the control group. In contrast, their blood magnesium and BMP-7 levels were notably lower than those of the control group, with statistical significance （P < 0.05）. Pearson correlation showed positive correlations between serum magnesium and serum calcium, phosphorus, calcium-phosphorus product, 25-（OH）-VitD3, and BMP-7 （r = 0.385, 0.183, 0.141, 0.131, 0.458, P < 0.05）; between serum calcium and serum phosphorus, calcium-phosphorus product, iPTH, AACS, 25-（OH）-VitD3, and BMP-7 （r = 0.318）, correlation （r = 0.318, 0.311, 0.098, 0.170 , 0.277, 0.485, P < 0.05）; between serum phosphorus and calcium-phosphorus product, iPTH, AACS, 25-（OH）-VitD3 （r = 0.362, 0.506, 0.367, 0.461, P < 0.05）; between calcium-phosphorus product and iPTH, AACS, 25-（OH）-VitD3 （r = 0.542, 0.373, 0.434, P < 0.05）; between iPTH and AACS, 25-（OH）-VitD3 showing positive correlations （r = 0.553, 0.616, P < 0.05） and a negative correlation with BMP-7 （r = -0.373, P < 0.05）; between AACS and 25-（OH）-VitD3 showing a positive correlation （r = 0.402, P < 0.05）, and a negative correlation with BMP-7 （r = -0.155, P < 0.05）, with statistically significant differences （P < 0.05）. Statistically significant differences were noted between the two groups in age, diabetes, serum magnesium, serum calcium, serum phosphorus, calcium-phosphorus product, 25-（OH）-VitD3, and hs-CRP （P < 0.05）. Logistic regression analysis showed that age, serum magnesium, serum calcium, serum phosphorus, calcium phosphate product, 25- （OH） -vitamin I were all risk factors for cardiovascular disease （CVD） mortality in maintenance hemodialysis （MHD） patients （P <0.05）. ROC curve analysis showed that serum magnesium, serum calcium, and serum phosphorus had predictive areas under the curve （AUC） of 0.895, 0.802, and 0.851 for CVD mortality in MHD patients, with sensitivities and specificities of 87.5%/98.7%, 66.7%/90.8%, and 72.9%/100%, respectively. The combined prediction for CVD mortality in MHD patients showed an AUC of 0.921, with a sensitivity of 81.3% and specificity of 93.4%. Conclusion MHD patients exhibit low blood magnesium levels, elevated serum phosphorus concentrations, and increased calcium-phosphorus product, with complex correlations among these biomarkers. Age, magnesium, calcium, and phosphorus levels were all associated with CVD mortality. ROC curve analysis demonstrates that magnesium, calcium, and phosphorus, both individually and in combination, have high predictive value for CVD mortality risk.
- Maintenance hemodialysis,
- Blood magnesium level,
- Serum phosphorus concentration,
- Vascular calcification,
- Cardiovascular disease,
- Correlation prediction

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