ArticleEuropean journal of clinical pharmacology2026
Association between magnesium sulfate administration and mortality in critically ill patients with sepsis-associated acute kidney injury: a retrospective propensity score-matched cohort study.
Article in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe effect of magnesium sulfate on long-term outcomes in patients with sepsis-associated acute kidney injury (SA-AKI) remains unknown. This study aimed to evaluate its association with long-term mortality in SA-AKI patients.
methodsWe retrospectively analyzed data on patients with SA-AKI from the Medical Information Mart for Intensive Care-IV database. Magnesium sulfate administration after SA-AKI onset was defined as the exposure. Patients were matched 1:1 using propensity score matching (PSM). The primary endpoint was 1-year mortality; secondary endpoints included ICU mortality, in-hospital mortality, 28-day mortality, and major adverse kidney events within 30 days (MAKE30). Associations were assessed using multivariable analyses to calculate hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs).
resultsAmong 16,156 patients, 13,672 received magnesium sulfate. After PSM, 4936 patients (2468 per group) were included. In the PSM cohort, 1-year mortality was lower in the magnesium sulfate group than in the non-use group (41.21% vs. 47.41%; P < 0.001). Magnesium sulfate administration was significantly associated with reduced 1-year mortality (HR, 0.77; 95% CI, 0.71–0.84; P < 0.001), consistent across all subgroup. MAKE30 incidence was also lower in the magnesium sulfate group (33.14% vs. 38.41%; P < 0.001), with a significant associated (OR, 0.83; 95% CI, 0.73–0.94; P = 0.004). Additionally, magnesium sulfate was associated with reduced ICU mortality, in-hospital mortality, and 28-day mortality. Sensitivity analysis performed in the original cohort also demonstrated similar results.
conclusionMagnesium sulfate administration was associated with reduced long-term mortality in SA-AKI patients. These findings warrant confirmation through randomized controlled trials.
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