The age-old axiom that one is as old as his or her vessels are, calls for ongoing
critical re-examination of modifiable risk factors of accelerated vascular ageing
in chronic kidney diseases. Attempts to modulate vascular risk with cholesterol-lowering
agents have largely failed in advanced chronic kidney disease (CKD). In addition to
nitrogen waste products, many pathological biochemical processes also play a role
in vascular calcification in chronic kidney damage. Magnesium, a cation vital for
the body, may substantially reduce cardiovascular diseases’ risk and progression.
This narrative review aimed to address the relationship between hypomagnesemia and
vascular calcification, which promotes further cardiovascular complications in diabetes,
aging, and CKD. Articles with predefined keywords were searched for in the PubMed
and Google Scholar databases with specific inclusion and exclusion criteria. We hypothesized
that a decrease in serum magnesium levels contributes to increased vascular calcification
and thereby increases cardiovascular mortality. In summary, based on existing evidence
in the literature, it appears that simple and inexpensive oral magnesium supplementation
may reduce the cardiovascular mortality of patients who are already severely affected
by such diseases; in this context, the concept of ‘normal’ vs. ‘ideal’ serum magnesium
levels should be carefully re-examined.
