Acute kidney injury (AKI) is an acute and severe disease that threat to human health significantly. The occurrence of AKI tends to delay patients’ recovery and reduces their long-term quality of life. In the absence of specific treatments, early diagnosis and intervention are crucial for improving the prognosis of AKI patients. The alteration in serum magnesium concentration is associated with the occurrence and prognosis of AKI, and play an important role in its diagnosis and treatment. This review presents a summary of the distribution and homeostatic regulation of magnesium, as well as the correlation between serum magnesium imbalance and AKI, the potential mechanism of AKI induced by magnesium ion disorders, and cites the application of magnesium supplementation in the prevention and treatment of AKI. By enhancing public understanding of human magnesium homeostasis through this article, this article aims to raise awareness among clinicians regarding the relationship between serum magnesium imbalance and AKI, and to correct dysmagnesemia in a timely manner, to improved prognosis for AKI patients ultimately.

1.Yang X, Chen C, Teng S, et al. Urinary matrix metalloproteinase-7 poredicts severe AKI and poor outcomes after cardiac surgery[J]. J Am Soc Nephrol, 2017, 28(11): 3373-3382. DOI: 10.1681/ASN.2017020142.

2.Yang X, Chen C, Tian J, et al. Urinary angiotensinogen level predicts AKI in acute decompensated heart failure: a prospective, two-stage study[J]. J Am Soc Nephrol, 2015, 26(8): 2032-2041. DOI: 10.1681/ASN.2014040408.

3.Deng Y, Chi R, Chen S, et al. Evaluation of clinically available renal biomarkers in critically ill adults: a prospective multicenter observational study[J]. Crit Care, 2017, 21(1): 46. DOI: 10.1186/s13054-017-1626-0.

4.Xu X, Nie S, Liu Z, et al. Epidemiology and clinical correlates of AKI in Chinese hospitalized adults[J]. Clin J Am Soc Nephrol, 2015, 10(9): 1510-1518. DOI: 10.2215/CJN.02140215.

5.陈杰桓, 许志荣, 刘颖培, 等. 超声造影对急性肾损伤治疗后肾血流灌注水平的评价[J]. 中华腔镜泌尿外科杂志（电子版）, 2023, 17(1): 58-62.[Chen JH,Xu  ZR, Liu YP, et al. Evaluation of renal perfusion level after continuous renal replacement therapy for septic acute renal injury by contrast-enhanced ultrasound[J]. Chinese Journal of Endourology (Electronic Edition), 2023, 17(1): 58-62.] DOI: 10.3877/cma.j.issn.1674-3253.2023.01.013.

6.Chen Y, Li Z, Zhang H, et al. Mitochondrial metabolism and targeted treatment strategies in ischemic-induced acute kidney injury[J]. Cell Death Discov, 2024, 10(1): 69. DOI: 10.1038/s41420-024-01843-5.

7.Turgut F, Awad AS, Abdel-Rahman EM. Acute kidney injury: medical causes and pathogenesis[J]. J Clin Med, 2023, 12(1): 375. DOI: 10.3390/jcm12010375.

8.陈剑平, 李常慧, 黄诗莹, 等. 基于成分表征和网络药理学研究黄芪丹参煎液治疗急性肾损伤的质量标志物[J]. 中国药师, 2022, 25(12): 2079-2086. [Chen  JP, Li CH, Huang SY, et al. Study on the Q-Markers for huangqi-danshen decoction in the treatment of acute kidney injury based on constituents characterization and network pharmacology[J]. China Pharmacist, 2022, 25(12): 2079-2086.] DOI: 10.19962/j.cnki.issn1008-049X.2022.12.004.

9.Xie JZ, Huang Y, Zheng XF, et al. The association between serum magnesium and chronic kidney disease in Chinese adults: a cross-sectional study[J]. BMC Public Health, 2024, 24(1): 187. DOI: 10.1186/s12889-023-17615-2.

10.Pethő ÁG, Tapolyai M, Browne M, et al. Hypomagnesemia as a risk factor and accelerator for vascular aging in diabetes mellitus and chronic kidney disease[J]. Metabolites, 2023, 13(2): 306. DOI: 10.3390/metabo13020306.

11.Barbagallo M, Veronese N, Dominguez LJ. Magnesium in type 2 diabetes mellitus, obesity, and metabolic syndrome[J]. Nutrients, 2022, 14(3): 714. DOI: 10.3390/nu14030714.

12.Al Alawi AM, Al Badi A, Al Huraizi A, et al. Magnesium: the recent research and developments[J]. Adv Food Nutr Res, 2021, 96: 193-218. DOI: 10.1016/bs.afnr. 2021.01.001.

13.Salinas M, López-Garrigós M, Flores E, et al. Improving diagnosis and treatment of hypomagnesemia[J]. Clin Chem Lab Med, 2023, 62(2): 234-248. DOI: 10.1515/cclm-2023-0537.

14.Seah S, Tan YK, Teh K, et al. Proton-pump inhibitor use amongst patients with severe hypomagnesemia[J]. Front Pharmacol, 2023, 14: 1092476. DOI: 10.3389/fphar. 2023.1092476.

15.Adomako EA, Yu ASL. Magnesium disorders: core curriculum 2024[J]. Am J Kidney Dis, 2024, 83(6): 803-815. DOI: 10.1053/j.ajkd.2023.10.017.

16.Fritzen R, Davies A, Veenhuizen M, et al. Magnesium deficiency and cardiometabolic disease[J]. Nutrients, 2023, 15(10): 2355. DOI: 10.3390/nu15102355.

17.Cheungpasitporn W, Thongprayoon C, Erickson SB. Admission hypomagnesemia and hypermagnesemia increase the risk of acute kidney injury[J]. Ren Fail, 2015, 37(7): 1175-1179. DOI: 10.3109/0886022X.2015.1057471.

18.梁士楚, 张静, 李静, 等. 药物干预措施预防冠心病介入术后对比剂相关急性肾损伤效果的系统评价再评价 [J]. 中国循证医学杂志, 2022, 22(5): 575-584. [Liang SC, Zhang J, Li J, et al. Efficacy of different pharmacological interventions in the prevention of contrastinduced acute kidney injury after percutaneous coronary intervention: an overview of systematic reviews[J].Chinese Journal of Evidence-Based Medicine，2022, 22(5): 575-584.] DOI: 10.7507/1672-2531.202112124.

19.Lv Q, Li D, Wang Y, et al. Admission electrolyte and osmotic pressure levels are associated with the incidence of contrast-associated acute kidney injury[J]. Sci Rep, 2022, 12(1): 4714. DOI: 10.1038/s41598-022-08597-z.

20.Ribeiro HS, Burdmann EA, Vieira EA, et al. Association of magnesium abnormalities at intensive care unit admission with kidney outcomes and mortality: a prospective cohort study[J]. Clin Exp Nephrol, 2022, 26(10): 997-1004. DOI: 10.1007/s10157-022-02245-6.

21.Xiong C, Shi S, Cao L, et al. Association of early postoperative serum magnesium with acute kidney injury after cardiac surgery[J]. Ren Fail, 2023, 45(1): 2170244. DOI: 10.1080/0886022X.2023.2170244.

22.苏一奇, 沈道琪, 王一梅, 等. 急诊住院患者急性肾损伤的预测模型构建[J]. 中国临床医学, 2021, 28(4): 562-567. [Su YQ, Shen DQ, Wang YM, et al. Establishment of a predictive model for acute kidney injury in emergency inpatients[J]. Chinese Journal of Clinical Medicine, 2021, 28(4): 562-567.] DOI: 10.12025/j.issn. 1008-6358.2021.20201944.

23.Zheng L, Lin Y, Fang K, et al. Derivation and validation of a risk score to predict acute kidney injury in critically ill cirrhotic patients[J]. Hepatol Res, 2023, 53(8): 701-712. DOI: 10.1111/hepr.13907.

24.Stevens JS, Moses AA, Nickolas TL, et al. Increased mortality associated with hypermagnesemia in severe COVID-19 illness[J]. Kidney360, 2021, 2(7): 1087-1094. DOI: 10.34067/KID.0002592021.

25.Morooka H, Tanaka A, Kasugai D, et al. Abnormal magnesium levels and their impact on death and acute kidney injury in critically ill children[J]. Pediatr Nephrol, 2022, 37(5): 1157-1165. DOI: 10.1007/s00467-021-05331-1.

26.Iotti S, Wolf F, Mazur A, et al. The COVID-19 pandemic: is there a role for magnesium? Hypotheses and perspectives[J]. Magnes Res, 2020, 33(2): 21-27. DOI: 10.1684/mrh.2020.0465.

27.Koh HB, Jung CY, Kim HW, et al. Preoperative ionized magnesium levels and risk of acute kidney injury after cardiac surgery[J]. Am J Kidney Dis, 2022, 80(5): 629-637, e1. DOI: 10.1053/j.ajkd.2022.03.004.

28.Verwijmeren L, Bosma M, Vernooij LM, et al. Associations between preoperative biomarkers and cardiac surgery-associated acute kidney injury in elderly patients: a cohort study[J]. Anesth Analg, 2021, 133(3): 570-577. DOI: 10.1213/ANE.0000000000005650.

29.Yu XQ, Deng HB, Liu Y, et al. Serum magnesium level as a predictor of acute kidney injury in patients with acute pancreatitis[J]. World J Clin Cases, 2021, 9(35): 10899-10908. DOI: 10.12998/wjcc.v9.i35.10899.

30.Liu Z, Wang R, He M, et al. Hypomagnesemia is associated with the acute kidney injury in traumatic brain injury patients: a pilot study[J]. Brain Sci, 2023, 13(4): 593. DOI: 10.3390/brainsci13040593.

31.Shen D, Wang Y, Xu J, et al. The effect of admission serum magnesium on the acute kidney injury among patients with malignancy[J]. Cancer Manag Res, 2020, 12: 7199-7207. DOI: 10.2147/CMAR.S262674.

32.李晶, 张春秀, 李玉凤, 等. 低镁血症对急性肾损伤患者肾脏预后的预测价值[J]. 肾脏病与透析肾移植杂志, 2021, 30(2): 124-129. [Li J, Zhang CX, Li YF，et al. Predictive value of hypomagnesemia on renal prognosis in patients with acute kidney injury[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2021, 30(2): 124-129.] DOI: 10.3969/j.issn.1006-298X.2021.02.005.

33.Chen Y, Mo Z, Chu H, et al. A model for predicting postoperative persistent acute kidney injury (AKI) in AKI after cardiac surgery patients with normal baseline renal function[J]. Clin Cardiol, 2024, 47(1): e24168. DOI: 10.1002/clc.24168.

34.Kudryavtseva O, Lyngsø KS, Jensen BL, et al. Nitric oxide, endothelium-derived hyperpolarizing factor, and smooth muscle-dependent mechanisms contribute to magnesium-dependent vascular relaxation in mouse arteries[J]. Acta Physiol (Oxf), 2024, 240(3): e14096. DOI: 10.1111/apha. 14096.

35.Wang D, Li ZX, Jiang DM, et al. Magnesium ions improve vasomotor function in exhausted rats[J]. PLoS One, 2023, 18(2): e0279318. DOI: 10.1371/journal.pone.0279318.

36.Correa S, Guerra-Torres XE, Waikar SS, et al. Serum magnesium, blood pressure, and risk of hypertension and chronic kidney disease progression in the CRIC study[J]. Hypertension, 2021, 78(6): 1771-1780. DOI: 10.1161/HYPERTENSIONAHA.121.17694.

37.Akan M, Ozbilgin S, Boztas N, et al. Effect of magnesium sulfate on renal ischemia-reperfusion injury in streptozotocin-induced diabetic rats[J]. Eur Rev Med Pharmacol Sci, 2016, 20(8): 1642-1655. https://pubmed.ncbi.nlm.nih.gov/27160141/.

38.Celik Kavak E, Gulcu Bulmus F, Bulmus O, et al. Magnesium: does it reduce ischemia/reperfusion injury in an adnexal torsion rat model?[J]. Drug Des Devel Ther, 2018, 12: 409-415. DOI: 10.2147/DDDT.S157115.

39.Shahi A, Aslani S, Ataollahi M, et al. The role of magnesium in different inflammatory diseases[J]. Inflammopharmacology, 2019, 27(4): 649-661. DOI: 10.1007/s10787-019-00603-7.

40.Li J, Chen J, Lan HY, et al. Role of C-reactive protein in kidney diseases[J]. Kidney Dis (Basel), 2022, 9(2): 73-81. DOI: 10.1159/000528693.

41.Dong H, Hu P, Wang J, et al. Serum calcium and magnesium were inversely associated with high sensitivity C-reactive protein in Chinese adults with coronary artery disease[J]. Curr Med Res Opin, 2023, 39(4): 497-503. DOI: 10.1080/03007995.2023.2185392.

42.Maier JA, Castiglioni S, Locatelli L, et al. Magnesium and inflammation: advances and perspectives[J]. Semin Cell Dev Biol, 2021, 115: 37-44. DOI: 10.1016/j.semcdb.2020. 11.002.

43.Veronese N, Pizzol D, Smith L, et al. Effect of magnesium supplementation on inflammatory parameters: a Meta-analysis of randomized controlled trials[J]. Nutrients, 2022, 14(3): 679. DOI: 10.3390/nu14030679.

44.Kisters S, Kisters K, Werner T, et al. Magnesium supplementation reduces interleukin-6 levels in metabolic syndrome[J]. Magnes Res, 2023, 36(1): 22. DOI: 10.1684/mrh.2023.0511.

45.Huang J, Xu J, Ye P, et al. Association between magnesium intake and the risk of anemia among adults in the United States[J]. Front Nutr, 2023, 10: 1046749. DOI: 10.3389/fnut.2023.1046749.

46.Oh TK, Oh AY, Ryu JH, et al. Retrospective analysis of the association between intraoperative magnesium sulfate infusion and postoperative acute kidney injury after major laparoscopic abdominal surgery[J]. Sci Rep, 2019, 9(1): 2833. DOI: 10.1038/s41598-019-39106-4.

47.Suppadungsuk S, Phitakwatchara W, Reungwetwattana  T, et al. Preloading magnesium attenuates cisplatin-associated nephrotoxicity: pilot randomized controlled trial (PRAGMATIC study)[J]. ESMO Open, 2022, 7(1): 100351. DOI: 10.1016/j.esmoop.2021.100351.

48.Money ME, Hamroun A, Shu Y, et al. Case report and supporting documentation: acute kidney injury manifested as oliguria is reduced by intravenous magnesium before cisplatin[J]. Front Oncol, 2021, 11: 607574. DOI: 10.3389/fonc.2021.607574.

49.Barbosa EB, Tomasi CD, de Castro Damasio D, et al. Effects of magnesium supplementation on the incidence of acute kidney injury in critically ill patients presenting with hypomagnesemia[J]. Intensive Care Med, 2016, 42(6): 1084-1085. DOI: 10.1007/s00134-016-4276-9.

50.林小青, 尹文俊, 周凌云, 等. 万古霉素联用哌拉西林他唑巴坦致急性肾损伤的研究进展[J]. 药物流行病学杂志, 2023, 32(9): 975-984. [Lin XQ, Yin WJ , Zhou LY, et al. Research progress of vancomycin combined with piperacillin/tazobactam induced acute kidney injury[J].Chinese Journal of Pharmacoepidemiology, 2023, 32(9): 975-984.] DOI: 10.19960/j.issn.1005-0698.202309003.

51.Khalili H, Rahmani H, Mohammadi M, et al. Intravenous magnesium sulfate for prevention of vancomycin plus piperacillin-tazobactam induced acute kidney injury in critically ill patients: an open-label, placebo-controlled, randomized clinical trial[J]. Daru, 2021, 29(2): 341-351. DOI: 10.1007/s40199-021-00411-x.

52.Gu WJ, Duan XJ, Liu XZ, et al. Association of magnesium sulfate use with mortality in critically ill patients with sepsis: a retrospective propensity score-matched cohort study[J]. Br J Anaesth, 2023, 131(5): 861-870. DOI: 10.1016/j.bja.2023.08.005.