{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:28:17Z","timestamp":1793381297515,"version":"4.5.0"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Magnesium (Mg) contributes to DNA stability, protein synthesis and cardiac excitability, while Mg deficiency leads to increased cardiovascular mortality, diabetes, hyperparathyroidism and risk of fractures. In kidney transplant patients, calcineurin inhibitors (CNIs) downregulating Mg channel TRPM6 in the distal collecting tubule induce early hypomagnesemia (HypoMg), which is associated with a faster decline in allograft function. A new formulation, sucrosomial Mg (SucrMg), for oral supplements encapsulates Mg oxide in a phospholipid membrane covered by a sucrester matrix, enhancing gastric and intestinal Mg absorption. This study has evaluated Mg bioavailability, effectiveness and tolerance of SucrMg compared to the conventional preparation of Mg pidolate (PidMg). The association of blood Mg with risk of post-transplant dysglycemia and hyperparathyroidism has also been investigated. Forty hypomagnesemic adult single, double or combined kidney\u2013pancreas or kidney\u2013liver transplant recipients within 2 years from transplantation were recruited. In total, 16 patients received PidMg and 27 received SucrMg. Blood Mg was measured at baseline (T0), after 15 days (T1) and after 6 months (T2) of treatment. PTH, fasting glucose and calcium were measured at baseline and after 6 months of treatment. The tolerance was evaluated at the ambulatory visits. SucrMg compared to PidMg was more efficient at increasing Mg bioavailability at T1: p &lt; 0.0001 vs. p = 0.72 ns, respectively, with a \u2206% increase of 12.4% vs. 5.4%, p = 0.04. Both preparations increased blood Mg at T2, p &lt; 0.0001 and p = 0.002, respectively. SucrMg was better tolerated. No difference was observed for fasting plasma glucose, PTH and calcium. On one hand, our study is the first among transplant patients to evaluate the efficacy of SucrMg in the correction of HypoMg, which might justify the limited number of patients enrolled and the short observation time; on the other hand, our results could serve as a useful working hypothesis for further studies with a larger number of transplant patients and an extended study duration to confirm the benefits observed with SucrMg.<\/jats:p>","DOI":"10.3390\/jcm12030752","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T03:04:44Z","timestamp":1674011084000},"page":"752","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Calcineurin-Inhibitor-Induced Hypomagnesemia in Kidney Transplant Patients: A Monocentric Comparative Study between Sucrosomial Magnesium and Magnesium Pidolate Supplementation"],"prefix":"10.3390","volume":"12","author":[{"given":"Lucia Federica","family":"Stefanelli","sequence":"first","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Alessi","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6498-6671","authenticated-orcid":false,"given":"Giovanni","family":"Bertoldi","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Rossato","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-5780","authenticated-orcid":false,"given":"Valentina","family":"Di Vico","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1167-2764","authenticated-orcid":false,"given":"Federico","family":"Nalesso","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7534-0128","authenticated-orcid":false,"given":"Lorenzo A.","family":"Cal\u00f2","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Medicine, University of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1152\/physrev.00012.2014","article-title":"Magnesium in man: Implications for health and disease","volume":"95","author":"Hoenderop","year":"2015","journal-title":"Physiol Rev."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ahmed, F., and Mohammed, A. (2019). Magnesium: The Forgotten Electrolyte-A Review on Hypomagnesemia. Med. Sci., 7.","DOI":"10.3390\/medsci7040056"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/MNH.0000000000000238","article-title":"Mechanisms and causes of hypomagnesemia","volume":"25","author":"Agus","year":"2016","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.trre.2015.05.002","article-title":"Hypomagnesaemia in kidney transplantation","volume":"29","year":"2015","journal-title":"Transpl. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Garnier, A., Duveau, A., Planchais, A., Subra, J.F., Sayegh, J., and Augusto, J.F. (2018). Serum magnesium after kidney transplantation: A systematic review. Nutrients, 10.","DOI":"10.3390\/nu10060729"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1432-2277.2003.tb00267.x","article-title":"Long-term calcineurin inhibition and magnesium balance after renal transplantation","volume":"16","author":"Mazzola","year":"2003","journal-title":"Transpl. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1097\/00007890-200209270-00009","article-title":"Magnesium supplementation prevents experimental chronic cyclosporine a nephrotoxicity via renin-angiotensin system independent mechanism","volume":"74","author":"Asai","year":"2002","journal-title":"Transplantation"},{"key":"ref_8","first-page":"1843","article-title":"Magnesium bioavailability after administration of sucrosomial\u00ae magnesium: Results of an ex-vivo study and a comparative, double-blinded, cross-over study in healthy subjects","volume":"22","author":"Brilli","year":"2018","journal-title":"Eur. Rev. Med. Pharm. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3107","DOI":"10.1002\/jps.24085","article-title":"Sucrose esters increase drug penetration, but do not inhibit p-glycoprotein in caco-2 intestinal epithelial cells","volume":"103","author":"Kiss","year":"2014","journal-title":"J. Pharm. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s40560-018-0291-y","article-title":"Hypomagnesemia in critically ill patients","volume":"6","author":"Hansen","year":"2018","journal-title":"J. Intensive Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"219","DOI":"10.2147\/IJNRD.S42054","article-title":"Hypomagnesemia: A clinical perspective","volume":"7","author":"Pham","year":"2014","journal-title":"Int. J. Nephrol. Renovasc. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/j.1399-0012.2011.01425.x","article-title":"Single-dose rATG induction at renal transplantation: Superior renal function and glucoregulation with less hypomagnesemia","volume":"26","author":"Stevens","year":"2012","journal-title":"Clin. Transpl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1093\/ndt\/gfh831","article-title":"Low serum magnesium is associated with decreased graft survival in patients with chronic cyclosporin nephrotoxicity","volume":"20","author":"Holzmacher","year":"2005","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/00045391-200109000-00008","article-title":"Bioavailability and pharmacokinetics of magnesium after administration of magnesium salts to humans","volume":"8","author":"Ranade","year":"2001","journal-title":"Am. J. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.diabet.2015.03.010","article-title":"Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial","volume":"41","year":"2015","journal-title":"Diabetes Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1111\/tri.12287","article-title":"The effect of magnesium supplements on early post-transplantation glucose metabolism: A randomized controlled trial","volume":"27","author":"Nagler","year":"2014","journal-title":"Transpl. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e251","DOI":"10.1097\/TP.0000000000004099","article-title":"Improvement of Mineral and Bone Disorders After Renal Transplantation","volume":"106","author":"Ferreira","year":"2022","journal-title":"Transplantation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e97292","DOI":"10.5812\/ijem.97292","article-title":"Association Between Pretransplant Magnesemia and Post-Transplant Dysglycemia in Kidney Transplant Recipients","volume":"18","author":"Alamdari","year":"2020","journal-title":"Int. J. Endocrinol. Metab."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/752\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:08:42Z","timestamp":1760119722000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/3\/752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,17]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["jcm12030752"],"URL":"https:\/\/doi.org\/10.3390\/jcm12030752","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,17]]}}}