We have quite a few patients with chronic kidney disease, maybe 60 percent of them test low in serum magnesium and red blood cell magnesium. We then recommend dietary and/or supplemental magnesium and monitor levels. But invariably their nephrologist tells him to stop any intake of magnesium regardless of levels. Can you elaborate on the chronic kidney disease and magnesium connection and what to be cautious of? In all fairness, roughly 30 percent of our chronic kidney disease patients will have high levels of magnesium and we obviously don’t recommend magnesium to them. Are there alternatives to dialysis?

Dr. Amy Nett:  Yeah, I mean, the concern with patients who have chronic kidney disease, especially if they’re on dialysis, is the body loses its own homeostatic mechanisms to regulate. So in a patient with normally functioning kidneys, the body’s able to regulate serum levels of these various compounds. But if you have a patient with chronic kidney disease, they’re not necessarily going to be able to perform that same sort of homeostatic regulation. So you have to be a lot more careful in supplementing in patients who have chronic kidney disease. Because they’re not necessarily going to be able to excrete the supplements. So you’re potentially going to be building up higher levels.

Well, but in chronic kidney disease, the kidneys aren’t functioning well. So even if they’re not yet on dialysis, their kidneys still aren’t functioning as well. And they’re going to have lost some kidney function. One of the jobs that the kidneys should be doing is regulating blood levels of magnesium and potassium, calcium, that sort of thing. So if the kidneys are not working well, I’m going to be cautious, whether or not that patient is on dialysis, I’m going to be really cautious about supplementation because their body won’t be able to regulate those levels quite as well, the nutrient levels quite as well.