Relationship between magnesium intake and decline in kidney function, incident chronic kidney disease and incident cardiovascular disease

Background and hypothesis: Higher magnesium (Mg) intake is associated with a lower risk of stroke, heart failure and mortality, while there are limited data with kidney disease outcomes. We hypothesized that higher dietary Mg intake would be associated with a lower incidence of cardiovascular disease (CVD), chronic kidney disease (CKD) and kidney function decline. Methods: and at least 1 mL/min/year decline from baseline. Incident CVD was defined as incident coronary disease, heart failure, stroke or cardiovascular mortality. Multivariable Poisson regression and Cox proportional hazards models were used to evaluate the association of Mg intake with kidney and cardiovascular outcomes, respectively. Results: After excluding missing data, 2682 individuals were available for analysis. The median daily dietary Mg intake was 278 mg/day (11.4 mmol/day) (25th-75th percentile: 214-350 mg/day). Among 1871 individuals without baseline CKD, 522 developed incident CKD, while within the whole cohort, 394 (14.7%) had a ≥30% decline in eGFR over 10 years. Higher Mg intake was independently associated with lower risk of 30% eGFR decline [incidence rate ratio (IRR) per standard deviation (SD) higher Mg intake = 0.79 (95% confidence interval 0.66, 0.93)] and with a lower risk of incident CKD [IRR per SD higher Mg intake = 0.84 (95% confidence interval 0.73, 0.96)]. Among 1968 individuals without baseline CVD, 634 developed incident CVD. There was no association between Mg intake and overall incident CVD [adjusted hazard ratio 0.98 (95% confidence interval 0.85, 1.13)]. Conclusions: Higher Mg intake was associated with a lower risk of 30% decline in eGFR and incident CKD but not with incident CVD in a large cohort of older adults. The impact of Mg supplementation on kidney outcomes warrants further investigation.