Trial reportJournal of the American Society of Nephrology : JASN2019
A Randomized Trial of Magnesium Oxide and Oral Carbon Adsorbent for Coronary Artery Calcification in Predialysis CKD.
Trial report in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
90 citing papers in PubMed, 1 synthesis or guideline pooled it, 149 citations in OpenAlex.
- Effect of magnesium on vascular calcification in chronic kidney disease patients: a systematic review and meta-analysis.Renal failure · 2023Pooled it
- Magnesium supplementation did not reduce serum calciprotein crystallization and arterial stiffness in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled trial.The American journal of clinical nutrition · 2026Trial
- Trial
- Multicenter Randomized Controlled Trial of Vitamin K Antagonist Replacement by Rivaroxaban with or without Vitamin K2 in Hemodialysis Patients with Atrial Fibrillation: the Valkyrie Study.Journal of the American Society of Nephrology : JASN · 2020Trial
- Association of serum magnesium levels and calcimimetic use: fractures and cardiovascular events in Japanese haemodialysis patients.Journal of bone and mineral metabolism · 2026Article
- Assessment and management of magnesium and trace element status in children with CKD stages 2-5, on dialysis and post-transplantation: Clinical practice points from the Pediatric Renal Nutrition Taskforce.Pediatric nephrology (Berlin, Germany) · 2025Review
- Exploring the relationship between serum magnesium levels, genetic variants and chronic kidney disease: a prospective study.Clinical kidney journal · 2025Article
- Soft tissue calcifications in chronic kidney disease-beyond the vasculature.Pflugers Archiv : European journal of physiology · 2025Review
- Relationship between magnesium intake and decline in kidney function, incident chronic kidney disease and incident cardiovascular disease.Clinical kidney journal · 2025Article
- Upper normal serum magnesium is associated with a reduction in incident death from fatal heart failure, coronary heart disease and stroke in non-dialysis patients with CKD stages 4 and 5.Clinical kidney journal · 2025Article
- Lower serum magnesium levels are associated with a higher risk of fractures and vascular calcifications in hemodialysis patients.Clinical kidney journal · 2025Article
- The effect of sevelamer on serum calcification propensity in patients with chronic kidney disease: the results of a multicentre, double-blind, placebo-controlled, randomized clinical trial.Clinical kidney journal · 2025Article
- Research progress on the association between TMAO and vascular calcification in patients with chronic kidney disease.Renal failure · 2024Review
- Article
- Association between serum magnesium levels and cognitive function in patients undergoing hemodialysis.Clinical and experimental nephrology · 2024Article
- The Dual Burden: Exploring Cardiovascular Complications in Chronic Kidney Disease.Biomolecules · 2024Review
- Lead Acetate-Injected Mice is an Animal Model for Extrapolation of Calcifying Response to Humans Due to Low Involvement of Bone Resorption.Calcified tissue international · 2024Article
- Association of serum magnesium levels with renal prognosis in patients with chronic kidney disease.Clinical and experimental nephrology · 2024Article
- Magnesium for disease treatment and prevention: emerging mechanisms and opportunities.Trends in pharmacological sciences · 2024Review
- Optic disc drusen: Dystrophic calcification, a potential target for treatment.Eye (London, England) · 2024Review
30 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDeveloping strategies for managing coronary artery calcification (CAC) in patients with CKD is an important clinical challenge. Experimental studies have demonstrated that magnesium inhibits vascular calcification, whereas the uremic toxin indoxyl sulfate aggravates it.
methodsTo assess the efficacy of magnesium oxide (MgO) and/or the oral carbon adsorbent AST-120 for slowing CAC progression in CKD, we conducted a 2-year, open-label, randomized, controlled trial, enrolling patients with stage 3-4 CKD with risk factors for CAC (diabetes mellitus, history of cardiovascular disease, high LDL cholesterol, or smoking). Using a two-by-two factorial design, we randomly assigned patients to an MgO group or a control group, and to an AST-120 group or a control group. The primary outcome was percentage change in CAC score.
resultsWe terminated the study prematurely after an interim analysis with the first 125 enrolled patients (of whom 96 completed the study) showed that the median change in CAC score was significantly smaller for MgO versus control (11.3% versus 39.5%). The proportion of patients with an annualized percentage change in CAC score of ≥15% was also significantly lower for MgO compared with control (23.9% versus 62.0%). However, MgO did not suppress the progression of thoracic aorta calcification. The MgO group's dropout rate was higher than that of the control group (27% versus 17%), primarily due to diarrhea. The percentage change in CAC score did not differ significantly between the AST-120 and control groups.
conclusionsMgO, but not AST-120, appears to be effective in slowing CAC progression. Larger-scale trials are warranted to confirm these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.