Effect of Oral Magnesium on Vascular Calcification in Chronic Kidney Disease

NCT ID: NCT02542319

Last Updated: 2022-09-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

148 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2021-07-31

Brief Summary

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Randomized placebo-controlled double-blinded interventional trial to investigate the effect of oral magnesium supplementation on vascular calcification in subjects with chronic kidney disease. We hypothesize that oral magnesium supplementation will reduce vascular calcification in subjects with chronic kidney disease while not decreasing bone mineral density.

Detailed Description

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Chronic kidney disease (CKD) is associated with increase cardiovascular morbidity and mortality independent of traditional cardiovascular risk factors due to increased vascular calcification. Epidemiological and experimental data suggest that hypermagnesemia and magnesium supplementation reduce vascular calcification in CKD by increasing calcium/phosphate solubility in serum, by inhibiting calcium influx into vascular smooth muscle cells (VSMC), by inhibiting intracellular pro-calcification enzymes in VSMC and by increasing activity of intracellular anti-calcification enzymes in VSMC. However, there have been concerns that any anti-calcification effect of magnesium might also reduce bone mineral density, in which case there might be an increased risk of bone fractures associated with magnesium supplementation in CKD. We wish to conduct a randomized placebo-controlled double-blinded interventional trial to examine whether oral magnesium supplementation will reduce vascular calcification in subjects with CKD while not decreasing bone mineral density.

Conditions

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Chronic Kidney Disease Vascular Calcification Uremic Osteodystrophy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized, double-blind, placebo-controlled, parallel-group
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Magnesium

Oral Magnesium Hydroxide (Mablet 360 mg) twice daily for 12 months.

Group Type EXPERIMENTAL

Mablet 360 mg

Intervention Type DIETARY_SUPPLEMENT

Placebo

Matching placebo tablets twice daily for 12 months.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

Interventions

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Mablet 360 mg

Intervention Type DIETARY_SUPPLEMENT

Placebo

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Estimated glomerular filtration rate between 45 and 15 mL/min for \> 3 months (i.e. CKD stage 3b-4).
* Serum total magnesium \< 0,82 mmol/L and serum phosphate \> 1,15 mmol/L on average of previous measurements.

or Serum total magnesium \< 0,92 mmol/L and serum phosphate \> 1,30 mmol/L on average of previous measurements.

* Life expectancy \> 1 year.
* Expected time until initiation of dialysis or transplantation \> 1 year.
* Women of childbearing age must be actively using contraceptive therapy (p-pills, estrogen depots or intrauterine device) as well as have a negative pregnancy test.
* Written informed consent.

Exclusion Criteria

* Current hemodialysis or peritoneal dialysis treatment.
* Kidney donor recipient.
* Previous coronary artery bypass graft (CABG).
* Parathyroid hormone \> 600 ρmol/L.
* Previous parathyroidectomy.
* Current treatment with magnesium containing medication or supplements.
* Any condition impairing magnesium absorption from the gastrointestinal tract (e.g. short bowel syndrome, chronic pancreatitis).
* Active malignancy (basal or squamous cell skin carcinoma, localized prostate cancer and cancer with no signs of reoccurrence after 5 years are exempt from this).
* Other diseases or conditions, which, in the opinion of the site investigator, would prevent participation in or completion of trial.
* Pregnancy or breastfeeding.
* Allergy towards contents of interventional medication.
* Participation in other interventional trials.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Herlev Hospital

OTHER

Sponsor Role collaborator

Nordsjaellands Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Iain O Bressendorff, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Nordsjaellands Hospital

Locations

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Herlev Hospital

Herlev, , Denmark

Site Status

Nordsjællands Hospital

Hillerød, , Denmark

Site Status

Akershus Universitetssykehus

Lørenskog, , Norway

Site Status

Countries

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Denmark Norway

References

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Bressendorff I, Hansen D, Schou M, Kragelund C, Svensson M, Hashemi B, Kristensen T, Vrist MH, Borg R, Tougaard B, Borg K, Hjortkjaer HO, Kristiansen CH, Carlson N, Nasiri M, Ashraf H, Pasch A, Brandi L. The Effect of Magnesium Supplementation on Vascular Calcification in CKD: A Randomized Clinical Trial (MAGiCAL-CKD). J Am Soc Nephrol. 2023 May 1;34(5):886-894. doi: 10.1681/ASN.0000000000000092. Epub 2023 Feb 2.

Reference Type DERIVED
PMID: 36749131 (View on PubMed)

Bressendorff I, Hansen D, Schou M, Kragelund C, Brandi L. The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a randomised clinical trial (MAGiCAL-CKD): essential study design and rationale. BMJ Open. 2017 Jun 23;7(6):e016795. doi: 10.1136/bmjopen-2017-016795.

Reference Type DERIVED
PMID: 28645983 (View on PubMed)

Other Identifiers

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MagiCal-CKD

Identifier Type: -

Identifier Source: org_study_id

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