Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation

Neetika Garg, Janice Weinberg, Sandeep Ghai, Gitana Bradauskaite, Matthew Nuhn, Amitabh Gautam, Nilay Kumar, Jean Francis, Joline L.T. Chen

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Background: Hypomagnesemia is associated with increased peripheral insulin resistance in the general population. It is frequently seen after renal transplantation. We examined its role as a risk factor for new-onset diabetes after transplantation (NODAT) and new-onset pre-diabetes after transplantation (NOPDAT). Methods: A retrospective analysis of 138 previously non-diabetic renal transplant recipients was conducted. Cox and logistic regression analyses were performed to examine the associations between 1-month post-transplant serum magnesium level and subsequent diagnoses of NODAT/NOPDAT. Results: NODAT was diagnosed in 34 (24.6 %) and NOPDAT in 12 (8.7 %) patients. Median time to diagnosis of NODAT/NOPDAT was 20.4 months (interquartile range [IQR] 6.8-34.8). Median follow up for the entire group was 3.5 years (IQR 2.3-5.6). Mean magnesium level at 1 month after transplantation was significantly lower in patients subsequently diagnosed with NODAT/NOPDAT (1.60 ± 0.27 vs. 1.76 ± 0.29 mg/dl, p = 0.002). Cox regression analysis identified a trend towards developing NODAT/NOPDAT with lower baseline magnesium levels (hazard ratio 0.89 per 0.1 mg/dl increment in magnesium level, 95 % confidence interval [CI] = 0.78-1.01, p = 0.07); a stronger relationship between the two variables was seen at logistic regression analysis (odds ratio 0.81 per 0.1 mg/dl increment in serum magnesium (95 % CI 0.67-0.98, p = 0.03). Conclusions: A lower magnesium level at 1 month after transplantation may be predictive of a subsequent diagnosis of glucose intolerance or diabetes in renal transplant recipients. Whether replenishing magnesium stores can prevent development of these disorders requires further investigation.

Original languageEnglish
Pages (from-to)339-344
Number of pages6
JournalJournal of Nephrology
Issue number3
StatePublished - Jun 2014
Externally publishedYes


  • Calcineurin inhibitors
  • Magnesium
  • New onset diabetes mellitus
  • New onset pre-diabetes
  • Renal transplantation


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