Evidence map›Paper›PMID 33149925›Full record

ReviewCanadian journal of kidney health and disease2020

A Higher Concentration of Dialysate Magnesium to Reduce the Frequency of Muscle Cramps: A Narrative Review.

Akshay Varghese, Eduardo Lacson, Jessica M Sontrop, Rey R Acedillo, Ahmed A Al-Jaishi, Sierra Anderson, Amit Bagga, Katie L Bain, Laura L Bennett, Clara Bohm and 25 more

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Canadian journal of kidney health and disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 18 citations in OpenAlex.

  1. Trial
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  3. A Narrative Summary of Strategies to Mitigate Intradialytic Hypotension in Poisoned Patients Requiring Extracorporeal Toxin Elimination.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors at 17 institutions in 2 countries.

Akshay VargheseDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
Eduardo LacsonDivision of Nephrology, Tufts University School of Medicine, Boston, MA, USA.
Jessica M SontropDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
Rey R AcedilloDepartment of Medicine, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada.
Ahmed A Al-JaishiDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.ORCID https://orcid.org/0000-0003-0376-2214
Sierra AndersonDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
Amit BaggaDivision of Nephrology, Department of Medicine, Windsor Regional Hospital, ON, Canada.
Katie L BainDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
Laura L BennettPatient Partner, BC Renal Agency, Vancouver, BC, Canada.
Clara BohmDepartment of Medicine, University of Manitoba, Winnipeg, MB, Canada.ORCID https://orcid.org/0000-0001-7710-7162
Pierre A BrownDepartment of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Christopher T ChanDivision of Nephrology, University Health Network, University of Toronto, ON, Canada.
Brenden CotePatient Partner, London Health Sciences Centre, London, ON, Canada.
Varun DevDepartment of Nephrology, Humber River Hospital, Toronto, ON, Canada.
Bonnie FieldPatient Partner, Patient and Family Advisory Council, London Health Sciences Centre, London, ON, Canada.
Claire HarrisDivision of Nephrology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Shasikara KalatharanCan-SOLVE CKD Network, Vancouver, BC, Canada.
Mercedeh KiaiiDivision of Nephrology, Department of Medicine, St Paul's Hospital, The University of British Columbia, Vancouver, BC, Canada.
Amber O MolnarDivision of Nephrology, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-4549-0202
Matthew J OliverDivision of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Malvinder S ParmarDepartment of Medicine, Timmins & District Hospital, Timmins, ON, Canada.ORCID https://orcid.org/0000-0003-3182-0530
Melissa SchorrDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.ORCID https://orcid.org/0000-0003-1076-770X
Nikhil ShahDivision of Nephrology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Samuel A SilverDepartment of Medicine, Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada.ORCID https://orcid.org/0000-0002-1843-6131
D Michael SmithPatient Partner, Patient and Family Advisory Council, London Health Sciences Centre, London, ON, Canada.
Manish M SoodDepartment of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-9146-2344
Irina St LouisDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
Karthik K TennankoreDivision of Nephrology, Department of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Stephanie ThompsonDivision of Nephrology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Marcello TonelliDivision of Nephrology, Department of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.
Hans VorsterCan-SOLVE CKD Network, Vancouver, BC, Canada.
Blair WaldvogelPatient Partner, Home Hemodialysis Department, Health Sciences Centre, Winnipeg, MB, Canada.
James ZachariasDepartment of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Amit X GargDivision of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.ORCID https://orcid.org/0000-0003-3398-3114
Dialysate Magnesium (Dial-Mag) Investigators
London Health Sciences Centre · CAUniversity of Alberta · CAUniversity of British Columbia · CAUniversity of Manitoba · CAUniversity of Ottawa · CABC Cancer Agency · CADalhousie University · CAHealth Sciences Centre · CAHumber River Regional Hospital · CAMcMaster University · CAQueen's University · CASunnybrook Health Science Centre · CAThunder Bay Regional Health Sciences Centre · CATufts University · USUniversity Health Network · CAUniversity of Calgary · CAWindsor Regional Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewStrategies to mitigate muscle cramps are a top research priority for patients receiving hemodialysis. As hypomagnesemia is a possible risk factor for cramping, we reviewed the literature to better understand the physiology of cramping as well as the epidemiology of hypomagnesemia and muscle cramps. We also sought to review the evidence from interventional studies on the effect of oral and dialysate magnesium-based therapies on muscle cramps. SOURCES OF INFORMATION: Peer-reviewed articles.

methodsWe searched for relevant articles in major bibliographic databases including MEDLINE and EMBASE. The methodological quality of interventional studies was assessed using a modified version of the Downs and Blacks criteria checklist. KEY

findingsThe etiology of muscle cramps in patients receiving hemodialysis is poorly understood and there are no clear evidence-based prevention or treatment strategies. Several factors may play a role including a low concentration of serum magnesium. The prevalence of hypomagnesemia (concentration of <0.7 mmol/L) in patients receiving hemodialysis ranges from 10% to 20%. Causes of hypomagnesemia include a low dietary intake of magnesium, use of medications that inhibit magnesium absorption (eg, proton pump inhibitors), increased magnesium excretion (eg, high-dose loop diuretics), and a low concentration of dialysate magnesium. Dialysate magnesium concentrations of ≤0.5 mmol/L may be associated with a decrease in serum magnesium concentration over time. Preliminary evidence from observational and interventional studies suggests a higher dialysate magnesium concentration will raise serum magnesium concentrations and may reduce the frequency and severity of muscle cramps. However, the quality of evidence supporting this benefit is limited, and larger, multicenter clinical trials are needed to further determine if magnesium-based therapy can reduce muscle cramps in patients receiving hemodialysis. In studies conducted to date, increasing the concentration of dialysate magnesium appears to be well-tolerated and is associated with a low risk of symptomatic hypermagnesemia. LIMITATIONS: Few interventional studies have examined the effect of magnesium-based therapy on muscle cramps in patients receiving hemodialysis and most were nonrandomized, pre-post study designs.

Indexed as

hemodialysishypomagnesemiamagnesiummuscle crampssafety

Identifiers

PMID33149925
PMCPMC7585892
OpenAlexW3094112299

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.