Magnesium Supplementation in Transplant Recipients

Forty transplant recipients who received a single, double or combined kidney–pancreas or kidney–liver transplants between 2019 and 2021 at the Kidney–Pancreas Transplant Unit of Padova University Hospital were enrolled. The patients were randomized to receive either Ultramag^® or Mag2^®.
All the study participants were followed at the Kidney–Pancreas Transplant Ambulatory Unit of Padova University Hospital. Treatment was started with very low levels of serum Mg (HypoMg is defined below 0.7 mmol/L or 1.7 mg/dL), developed within 6 months/1 year from transplantation. Patients’ tacrolimus trough levels were the same for both groups (between 6.5 and 8 μg/L). In total, 27 out of 40 patients were supplemented with 1 sachet of Ultramag^® (375 mg of Mg element)/day, while 16 were treated with 3 vials of Mag2^® (370 mg of Mg element/day) (Table 1). Three patients of the Mag2^® arm dropped out due to side effects after 1 month (diarrhea). Adult subjects (>18 years) of either gender were eligible. Other inclusion criteria were that patients must have undergone a single, double or combined kidney–pancreas or kidney–liver transplant between 2019 and 2021, and maintenance immunosuppressive therapy that consisted of CNI, mycophenolate/mTOR inhibitor and steroid, or CNI plus steroid-only treatment.
Patients were excluded if they had a history of intestinal resection, inflammatory disease of the gastrointestinal tract, malabsorption, presence of other drugs potentially affecting Mg reabsorption, such as diuretics, or genetic and familiar HypoMg.