The Impact of Magnesium Supplementation on Insulin Resistance and Secretion in Renal Transplant Recipients

The Impact of Magnesium Supplementation on Insulin Resistance and Secretion in Renal Transplant Recipients

Hypomagnesemia is common in renal transplant recipients and is mainly because of enhanced renal magnesium wasting, caused by immunosuppressive drugs (calcineurin inhibitors). Glucose metabolism disorders, including insulin resistance and decreased insulin secretion, are also prevalent post-transplantation and often precede the development of diabetes. As magnesium supplementation has been demonstrated to increase insulin sensitivity in both diabetic and non-diabetic patients, its potential therapeutic supplementation (post-transplantation) deserves further examination. The hypothesis is that magnesium supplementation in renal transplant recipients exerts a beneficial effect on insulin resistance and/or secretion.

Inclusion Criteria:

• Renal transplantation recipients
• > 18 years of age
• more than 4 months post-transplantation
• Hypomagnesemia < 1,8 milligram/deciliter on 2 consecutive blood samples (laboratory reference interval 1,7 - 2,55 milligram/deciliter) at least 1 month apart.

Exclusion Criteria:

• Pre-existing diabetes mellitus defined as the intake of anti-diabetic drugs at the time of inclusion
• Biopsy that proves acute rejection and consecutive treatment with corticosteroid boluses less than 2 months before inclusion
• Serum creatinine > 3 milligram/deciliter
• Active infection (C reactive protein > 3 milligram/deciliter)
• Severe hypomagnesemia (< 1,2 milligram/deciliter)
• Hypokalemia (< 3,5 milli-equivalent/liter)
• Severe hypocalcemia (< 6,5 milligram/deciliter)
• Intake of digoxin
• Intake of magnesium supplementation up to 2 weeks before randomization.