Dietary magnesium supplementation in cats with chronic kidney disease: A prospective double-blind randomized controlled trial.

Autor: Tang PK; Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom., van den Broek DHN; Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands., Jepson RE; Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom., Geddes RF; Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom., Chang YM; Research Support Office, Royal Veterinary College, University of London, London, United Kingdom., Lötter N; Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom., Moniot D; Royal Canin Research Center, Aimargues, France., Biourge V; Royal Canin Research Center, Aimargues, France., Elliott J; Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of veterinary internal medicine [J Vet Intern Med] 2024 Jul-Aug; Vol. 38 (4), pp. 2180-2195. Date of Electronic Publication: 2024 Jul 01.
DOI: 10.1111/jvim.17134
Abstrakt: Background: Plasma total magnesium concentration (tMg) is a prognostic indicator in cats with chronic kidney disease (CKD), shorter survival time being associated with hypomagnesemia. Whether this risk factor is modifiable with dietary magnesium supplementation remains unexplored.
Objectives: Evaluate effects of a magnesium-enriched phosphate-restricted diet (PRD) on CKD-mineral bone disorder (CKD-MBD) variables.
Animals: Sixty euthyroid client-owned cats with azotemic CKD, with 27 and 33 allocated to magnesium-enriched PRD or control PRD, respectively.
Methods: Prospective double-blind, parallel-group randomized trial. Cats with CKD, stabilized on a PRD, without hypermagnesemia (tMg >2.43 mg/dL) or hypercalcemia (plasma ionized calcium concentration, (iCa) >6 mg/dL), were recruited. Both intention-to-treat and per-protocol (eating ≥50% of study diet) analyses were performed; effects of dietary magnesium supplementation on clinicopathological variables were evaluated using linear mixed effects models.
Results: In the per-protocol analysis, tMg increased in cats consuming a magnesium-enriched PRD (β, 0.25 ± .07 mg/dL/month; P < .001). Five magnesium supplemented cats had tMg >2.92 mg/dL, but none experienced adverse effects. Rate of change in iCa differed between groups (P = .01), with decreasing and increasing trends observed in cats fed magnesium-enriched PRD and control PRD, respectively. Four control cats developed ionized hypercalcemia versus none in the magnesium supplemented group. Log-transformed plasma fibroblast growth factor-23 concentration (FGF23) increased significantly in controls (β, 0.14 ± .05 pg/mL/month; P = .01), but remained stable in the magnesium supplemented group (β, 0.05±.06 pg/mL/month; P =.37).
Conclusions and Clinical Importance: Magnesium-enriched PRD is a novel therapeutic strategy for managing feline CKD-MBD in cats, further stabilizing plasma FGF23 and preventing hypercalcemia.
(© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)
Databáze: MEDLINE
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