Objective  To explore the effect of serum magnesium level on arteriosclerosis in maintenance hemodialysis（MHD） patients.

Methods  From January 1, 2020 to June 30, 2023, 155 MHD patients were recruited. Based upon the tertile of average serum magnesium level, they were assigned into three groups of high magnesium group（blood magnesium≥1.82 mmol/L, n=50）, medium magnesium（1.61 mmol/L≤blood magnesium＜1.82 mmol/L） and low magnesium（blood magnesium ＜1.61 mmol/L, n=58）. Brachial-ankle pulse wave velocity（baPWV）, pulse pressure index（PPI）, intima-media thickness（IMT） of carotid artery and arteriosclerosis-related parameters were compared. Receiver operating characteristic（ROC） curve was plotted for examining the predictive value of magnesium ion level for arteriosclerosis in MHD patients.

Results  baPWV（1424.78 ± 224.51 vs 1342.00 ± 204.85、1301.24 ± 192.48）, pulse pressure index（PPI）（0.52 ± 0.13 vs 0.46 ± 0.13、0.44 ± 0.10） and IMT（1.24 ± 0.22 vs 1.08 ± 0.18、0.95 ± 0.21） were significantly higher in low magnesium group than those in medium/high magnesium group. There were statistically significant differences（P＜0.05）. Pearson’s correlation analysis indicated that serum magnesium level was significantly correlated negatively with baPWV and PPI（P＜0.05）. Binary Logistic regression analysis revealed that the influencing factors for the occurrence of arteriosclerosis were age（OR=1.072, P＜0.05）, hypertension（OR=2.764, P＜0.05）, serum phosphorus （OR=1.105, P＜0.05） and serum magnesium （OR=0.732, P＜0.05）. ROC curve analysis revealed that area under the curve（AUC） value was 0.872, optimal cut-off value 1.15 mmol/L and sensitivity 80.45% and specificity 64.32%.

Conclusion  As compared with moderate/high magnesium level, the related parameters of arteriosclerosis in MHD patients spike significantly with low magnesium level. And serum magnesium level has an excellent predictive value for the occurrence of arteriosclerosis.