{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T03:26:51Z","timestamp":1785036411814,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nephrol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In kidney transplant (KT) patients, magnesium (Mg<jats:sup>2+<\/jats:sup>) deficiency is widespread. It is often encountered early after KT, may persist longer, and is frequently promoted by calcineurin inhibitors (CNIs) and tubular leakage. Studies demonstrated an association between post-KT hypomagnesemia and allograft dysfunction. The concentration of the active form, the ionized Mg<jats:sup>2+<\/jats:sup> (iMg<jats:sup>2+<\/jats:sup>), is not measured clinically, and total Mg<jats:sup>2+<\/jats:sup> (tMg<jats:sup>2+<\/jats:sup>) and iMg<jats:sup>2+<\/jats:sup> correlations are conflicting. We assess the cross-sectional prevalence of hypomagnesemia in KT patients. The correlation of demographic and anthropometric parameters was also studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, single-center analysis of KT patients was conducted at the University Hospital of Bern, Switzerland (March 2023\u2013August 2023). Blood samples were collected at least twice for the majority of patients. tMg<jats:sup>2+<\/jats:sup> has been quantified from a plasma sample at the Clinical Chemistry Department of the University Hospital of Bern. The PRIME<jats:sup>\u00ae<\/jats:sup> ES analyzer (Nova Biomedical, USA) provided results for iMg<jats:sup>2+<\/jats:sup>. The following co-variables were considered: age, comorbidities, kidney disease, KT history, estimated glomerular filtration rate (eGFR), and treatment (including Mg<jats:sup>2+<\/jats:sup> supplementation and immunosuppression).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 208 measurements in 104 patients were performed [once in 9\/104 patients (8.7%), twice in 86\/104 (82.7%), and three times in 9\/104 (8.7%)]. Compared to that in healthy volunteers (51 measurements in 51 participants), mean iMg<jats:sup>2+<\/jats:sup> was significantly lower in KT patients {KT: 0.46 mmol\/L [interquartile range (IQR): 0.40\u20130.50], volunteers: 0.57 mmol\/L (IQR 0.54\u20130.61), p &amp;lt; 0.01}. Overall, iMg<jats:sup>2+<\/jats:sup> and tMg<jats:sup>2+<\/jats:sup> showed strong category agreement (r<jats:sup>2<\/jats:sup> = 0.93, p &amp;lt; 0.01). In linear regression, low iMg<jats:sup>2+<\/jats:sup> correlated with CNI exposure. For 110\/208 measurements (52.9%), a reduced iMg<jats:sup>2+<\/jats:sup> (cutoff: 0.42 mmol\/L) was shown. In 58\/208 (27.9%), both values were reduced, and 52\/208 (25%) had isolated reduced iMg<jats:sup>2+<\/jats:sup>. In principal component analysis, patients with isolated low iMg<jats:sup>2+<\/jats:sup> clustered with patients with low iMg<jats:sup>2+<\/jats:sup> and tMg<jats:sup>2+<\/jats:sup>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>iMg<jats:sup>2+<\/jats:sup> and tMg<jats:sup>2+<\/jats:sup> were strongly correlated. A substantial proportion of patients show isolated low iMg<jats:sup>2+<\/jats:sup>. Currently, it is unclear if these patients suffer from Mg<jats:sup>2+<\/jats:sup> deficiency.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneph.2024.1385447","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T05:10:54Z","timestamp":1721106654000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Magnesium matters: unveiling hidden risks in kidney transplant patients through total and ionized magnesium 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