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논문분류	춘계학술대회 초록집
제목	Hypomagnesemia Induced by Calcineurin Inhibitors in Pediatric Kidney Disease
저자	Minji Park
출판정보	2025; 2025(1):
키워드	Calcineurin inhibitor, Hypomagnesemia, Children
초록	Calcineurin inhibitors (CNIs) like tacrolimus and cyclosporine can cause various adverse effects, including hypomagnesemia in pediatric kidney diseases. This study aims to investigate the prevalence and risk factors of hypomagnesemia in pediatric patients treated with CNIs, providing insight into the management of this common electrolyte disturbance. A retrospective analysis was conducted on the medical records of 74 pediatric patients who were treated for kidney disease with calcineurin inhibitors (37 tacrolimus, 37 cyclosporine) from 2014 to 2024. During the study period, a total of 74 pediatric patients received calcineurin inhibitor treatment for nephrotic syndrome (65 patients), kidney transplantation (2 patients), and other chronic glomerulonephritis (7 patients). Before CNI treatment, the mean serum magnesium level was 2.03±0.21 mg/dL, and after treatment, it was 1.79±0.23 mg/dL. Of the 74 patients, 58 (78.4%) showed a decrease in serum magnesium level after CNI treatment compared to before treatment, with 81.1% in the tacrolimus group and 75.7% in the cyclosporine group showing a reduction. The mean reduction in serum magnesium levels was 0.35 mg/dL (range 0.02-1.0), with an average percentage decrease of 16.3% (range 1.1-43.9). The reduction in serum magnesium level was significantly greater in the tacrolimus group (decrease of 20.3%) compared to the cyclosporine group (decrease of 11.9%). Hypomagnesemia occurred in 10 patients (13.5%) after CNI treatment, with a significantly higher incidence in the tacrolimus group (9/37 patients, 24.3%) compared to the cyclosporine group (1/37 patients, 2.7%). Higher age, lower pre-treatment eGFR, and higher drug trough level were identified as risk factors for hypomagnesemia. This study demonstrates that CNIs are associated with a significant reduction in serum magnesium levels in pediatric patients with kidney disease. The findings highlight the need for careful monitoring of magnesium levels, especially in patients receiving tacrolimus, to prevent and manage hypomagnesemia effectively.
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