Association of Serum Magnesium Levels with Intradialytic Hypotension among Maintenance Haemodialysis Patients

Abstract

Background: Intradialytic complications such as hypotension, muscle cramps, nausea, headache, itching, and fever adversely affect patients’ well-being and treatment outcomes. Intradialytic hypotension (IDH) is the most common complication among haemodialysis patients. Previous studies suggest a relationship between serum magnesium levels and IDH in maintenance haemodialysis patients.
Objectives: To assess the relation of serum magnesium with intradialytic hypotension in maintenance haemodialysis patients.
Materials and Methods: This cross-sectional study included 100 patients receiving maintenance haemodialysis for more than 90 days, selected by purposive sampling. Blood pressure was measured before, during, and after haemodialysis. Serum magnesium and other relevant investigations were performed before and after dialysis. Data were analyzed using SPSS version 25 with paired t-test, Fisher’s exact test, and Chi-square test.
Results: Among the participants, 62% were male and 38% female. Diabetic nephropathy was the commonest primary disease (55%). IDH occurred in 42% of patients. In hypotensive patients, mean serum magnesium significantly decreased from 2.27±0.46 mg/dL before dialysis to 2.0±0.44 mg/dL after dialysis (p=0.002). No significant change was observed among non-hypotensive patients. Serum potassium, calcium, and phosphate levels significantly decreased after dialysis in both groups (p<0.001). No significant association was found between IDH and age, dialysis frequency, diabetes mellitus, ischemic heart disease, or interdialytic weight gain.
Conclusion: Significant reduction of serum magnesium during haemodialysis was associated with intradialytic hypotension. Maintaining adequate magnesium levels may help improve haemodynamic stability during dialysis.

KYAMC Journal Vol. 16, No. 04, January 2026: 162-168.