Introduction: The occurrence of acute kidney injury (AKI) is associated with a higher risk of mortality in patients with traumatic brain injury (TBI). This study aimed to explore the relationship between serum magnesium levels and the risk of AKI in patients with TBI. Methods: Patients with TBI were identified from the Medical Information Mart Intensive Care IV (MIMIC-IV) 2008–2019. The relationship between serum magnesium levels at admission and magnesium coefficient of variation (CV) during hospitalization and the risk of AKI was analyzed using multivariable logistic regression analysis and expressed as odds ratio (OR) and 95% confidence interval (CI). Subgroup analyses were performed according to Glasgow Coma Scale (GCS) score (<14, ≥14), sepsis (no, yes), and estimated glomerular filtration rate (eGFR; <60, ≥60). Results: Of the 991 patients included, 140 (14.13%) developed AKI during hospitalization. Patients with magnesium levels ≤1.7 mg/dL (tertile 1) (OR = 1.68, 95% CI: 1.01–2.81) were associated with a higher risk of AKI compared to those with magnesium levels of 1.7–2.0 mg/dL (tertile 2), but no association was found in those with magnesium levels >2.0 mg/dL (tertile 3) (p = 0.479). For magnesium CV, patients with magnesium CV >10% (tertile 3) (OR = 2.26, 95% CI: 1.16–4.41) were linked to an increased risk of AKI compared to those with magnesium CV ≤4% (tertile 1), but there may be a slight association between magnesium CV of 4%–10% (tertile 2) and AKI risk (OR = 1.86, 95% CI: 0.99–3.48; p = 0.053). Subgroup analyses showed that lower magnesium levels (≤1.7 mg/dL) or greater magnesium CV (>10%) were associated with a higher risk of AKI only in patients with a GCS score ≥14, non-sepsis, or eGFR ≥60 mL/min/1.73 m2 (p < 0.05). Conclusion: Lower serum magnesium levels at admission or greater magnesium CV during hospitalization were associated with a higher risk of AKI in patients with TBI.

1.
Mollayeva
T
,
Mollayeva
S
,
Colantonio
A
.
Traumatic brain injury: sex, gender and intersecting vulnerabilities
.
Nat Rev Neurol
.
2018
;
14
(
12
):
711
22
.
2.
Stocchetti
N
,
Carbonara
M
,
Citerio
G
,
Ercole
A
,
Skrifvars
MB
,
Smielewski
P
, et al
.
Severe traumatic brain injury: targeted management in the intensive care unit
.
Lancet Neurol
.
2017
;
16
(
6
):
452
64
.
3.
GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators
.
Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
.
Lancet Neurol
.
2019
;
18
(
1
):
56
87
.
4.
Hanafy
S
,
Xiong
C
,
Chan
V
,
Sutton
M
,
Escobar
M
,
Colantonio
A
, et al
.
Comorbidity in traumatic brain injury and functional outcomes: a systematic review
.
Eur J Phys Rehabil Med
.
2021
;
57
(
4
):
535
50
.
5.
Pesonen
A
,
Ben-Hamouda
N
,
Schneider
A
.
Acute kidney injury after brain injury: does it exist
.
Minerva Anestesiol
.
2021
;
87
(
7
):
823
7
.
6.
Barea-Mendoza
JA
,
Chico-Fernández
M
,
Quintana-Díaz
M
,
Serviá-Goixart
L
,
Fernández-Cuervo
A
,
Bringas-Bollada
M
, et al
.
Traumatic brain injury and acute kidney injury-outcomes and associated risk factors
.
J Clin Med
.
2022
;
11
(
23
):
7216
.
7.
De Vlieger
G
,
Meyfroidt
G
.
Kidney dysfunction after traumatic brain injury: pathophysiology and general management
.
Neurocrit Care
.
2023
;
38
(
2
):
504
16
.
8.
Albert
C
,
Haase
M
,
Albert
A
,
Zapf
A
,
Braun-Dullaeus
RC
,
Haase-Fielitz
A
.
Biomarker-guided risk assessment for acute kidney injury: time for clinical implementation
.
Ann Lab Med
.
2021
;
41
(
1
):
1
15
.
9.
Pickkers
P
,
Darmon
M
,
Hoste
E
,
Joannidis
M
,
Legrand
M
,
Ostermann
M
, et al
.
Acute kidney injury in the critically ill: an updated review on pathophysiology and management
.
Intensive Care Med
.
2021
;
47
(
8
):
835
50
.
10.
Volpe
SL
.
Magnesium in disease prevention and overall health
.
Adv Nutr
.
2013
;
4
(
3
):
378S
83S
.
11.
Laupland
KB
,
Tabah
A
,
Jacobs
N
,
Ramanan
M
.
Determinants of serum magnesium abnormalities and outcome among admissions to the intensive care unit
.
Anaesth Crit Care Pain Med
.
2020
;
39
(
6
):
793
7
.
12.
Shen
D
,
Wang
Y
,
Xu
J
,
Li
Y
,
Chen
X
,
Guo
M
, et al
.
The effect of admission serum magnesium on the acute kidney injury among patients with malignancy
.
Cancer Manag Res
.
2020
;
12
:
7199
207
.
13.
Yu
XQ
,
Deng
HB
,
Liu
Y
,
Qu
C
,
Duan
ZH
,
Tong
ZH
, et al
.
Serum magnesium level as a predictor of acute kidney injury in patients with acute pancreatitis
.
World J Clin Cases
.
2021
;
9
(
35
):
10899
908
.
14.
Koh
HB
,
Jung
CY
,
Kim
HW
,
Kwon
JY
,
Kim
NH
,
Kim
HJ
, et al
.
Preoperative ionized magnesium levels and risk of acute kidney injury after cardiac surgery
.
Am J Kidney Dis
.
2022
;
80
(
5
):
629
37.e1
.
15.
Liu
Z
,
Wang
R
,
He
M
,
Kang
Y
.
Hypomagnesemia is associated with the acute kidney injury in traumatic brain injury patients: a pilot study
.
Brain Sci
.
2023
;
13
(
4
):
593
.
16.
Shu
J
,
Zhang
C
,
Zheng
N
.
Financialization and sluggish fixed investment in Chinese real sector firms
.
Int Rev Econ Finance
.
2020
;
69
:
1106
16
.
17.
Mehta
RL
,
Kellum
JA
,
Shah
SV
,
Molitoris
BA
,
Ronco
C
,
Warnock
DG
, et al
.
Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury
.
Crit Care
.
2007
;
11
(
2
):
R31
.
18.
Levey
AS
,
Stevens
LA
,
Schmid
CH
,
Zhang
YL
,
Castro
AF
3rd
,
Feldman
HI
, et al
.
A new equation to estimate glomerular filtration rate
.
Ann Intern Med
.
2009
;
150
(
9
):
604
12
.
19.
Singer
M
,
Deutschman
CS
,
Seymour
CW
,
Shankar-Hari
M
,
Annane
D
,
Bauer
M
, et al
.
The third International consensus definitions for sepsis and septic shock (Sepsis-3)
.
JAMA
.
2016
;
315
(
8
):
801
10
.
20.
Pin-On
P
,
Saringkarinkul
A
,
Punjasawadwong
Y
,
Kacha
S
,
Wilairat
D
.
Serum electrolyte imbalance and prognostic factors of postoperative death in adult traumatic brain injury patients: a prospective cohort study
.
Medicine
.
2018
;
97
(
45
):
e13081
.
21.
Wang
GH
,
Yan
Y
,
Shen
HP
,
Chu
Z
.
The clinical characteristics of electrolyte disturbance in patients with moderate and severe traumatic brain injury who underwent craniotomy and its influence on prognosis
.
J Korean Neurosurg Soc
.
2023
;
66
(
3
):
332
9
.
22.
Corps
KN
,
Roth
TL
,
McGavern
DB
.
Inflammation and neuroprotection in traumatic brain injury
.
JAMA Neurol
.
2015
;
72
(
3
):
355
62
.
23.
Morooka
H
,
Tanaka
A
,
Kasugai
D
,
Ozaki
M
,
Numaguchi
A
,
Maruyama
S
.
Abnormal magnesium levels and their impact on death and acute kidney injury in critically ill children
.
Pediatr Nephrol
.
2022
;
37
(
5
):
1157
65
.
24.
Kahraman
S
,
Ozgurtas
T
,
Kayali
H
,
Atabey
C
,
Kutluay
T
,
Timurkaynak
E
.
Monitoring of serum ionized magnesium in neurosurgical intensive care unit: preliminary results
.
Clin Chim Acta
.
2003
;
334
(
1–2
):
211
5
.
25.
Mendez
DR
,
Corbett
R
,
Macias
C
,
Laptook
A
.
Total and ionized plasma magnesium concentrations in children after traumatic brain injury
.
Pediatr Res
.
2005
;
57
(
3
):
347
52
.
26.
Harrison-Felix
C
,
Whiteneck
G
,
Devivo
MJ
,
Hammond
FM
,
Jha
A
.
Causes of death following 1 year postinjury among individuals with traumatic brain injury
.
J Head Trauma Rehabil
.
2006
;
21
(
1
):
22
33
.
27.
Pandya
A
,
Chaput
KH
,
Schertzer
A
,
Moser
D
,
Guilfoyle
J
,
MacGillivray
S
, et al
.
Risk of infection and sepsis in pediatric patients with traumatic brain injury admitted to hospital following major trauma
.
Sci Rep
.
2018
;
8
(
1
):
9798
.
28.
Chawla
LS
,
Eggers
PW
,
Star
RA
,
Kimmel
PL
.
Acute kidney injury and chronic kidney disease as interconnected syndromes
.
N Engl J Med
.
2014
;
371
(
1
):
58
66
.
29.
Di Mario
F
,
Regolisti
G
,
Greco
P
,
Maccari
C
,
Superchi
E
,
Morabito
S
, et al
.
Prevention of hypomagnesemia in critically ill patients with acute kidney injury on continuous kidney replacement therapy: the role of early supplementation and close monitoring
.
J Nephrol
.
2021
;
34
(
4
):
1271
9
.
30.
Kostov
K
,
Halacheva
L
.
Role of magnesium deficiency in promoting atherosclerosis, endothelial dysfunction, and arterial stiffening as risk factors for hypertension
.
Int J Mol Sci
.
2018
;
19
(
6
):
1724
.
31.
Shahi
A
,
Aslani
S
,
Ataollahi
M
,
Mahmoudi
M
.
The role of magnesium in different inflammatory diseases
.
Inflammopharmacology
.
2019
;
27
(
4
):
649
61
.
32.
Cowan
JA
.
Structural and catalytic chemistry of magnesium-dependent enzymes
.
Biometals
.
2002
;
15
(
3
):
225
35
.
You do not currently have access to this content.