In the original edition of The Magnesium Miracle I did not have a specific section on kidney disease. That was mostly because for many decades the only advice for patients with kidney disease was to just avoid magnesium. Over the years, however, I’ve learned that the kidneys need magnesium just like any other organ and the attack on magnesium has little scientific merit. Magnesium is a biological necessity, and the blanket avoidance of it in kidney disease has led to untold suffering.
The NIH acknowledges a “growing burden of kidney disease.” Statistics show a sharp increase in kidney disease affecting one in ten American adults. But how are doctors diagnosing kidney disease these days? Perhaps they are setting the diagnostic criteria for kidney disease (in this case, filtration rates) at a lower level, much as they are doing with blood pressure and cholesterol. By having broader criteria, more people find themselves being diagnosed with pre-diabetes, pre-hypertension, and now pre–kidney disease and are terrified because they are being told they are developing chronic diseases for which there is no cure.
Catching more people in the net of pre–kidney disease means these patients will be offered medications for associated conditions, like heart disease, high blood pressure, and diabetes, that seem to go hand in hand with kidney disease.
I think part of the increase in kidney disease is due to the rampant use of prescription medications. But doctors do not want to admit that their treatments are causing harm. One paper published in 2009 thoroughly reviewed the problem of drug-induced kidney disease, finding that the kidneys can be damaged by a large number of therapeutic agents.42 Dr. Linda Fugate, Ph.D., lists the top ten classes of drugs that cause kidney damage and references the 2009 review article.43 Since that time, many more drugs have been implicated and the evidence is mounting that chronic use of medications instead of judicious short-term use is causing cumulative harm.
Top Ten Drug Families That Cause Kidney Damage
- Antibiotics, including ciprofloxacin, methicillin, vancomycin, and sulfonamides.
- Analgesics, including acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs): aspirin, ibuprofen, naproxen, and others available only by prescription.
- COX-2 inhibitors, including celecoxib (Celebrex). Two drugs in this class have been withdrawn from the market because of cardiovascular toxicity: rofecoxib (Vioxx) and valdecoxib (Bextra). COX-2 inhibitors were developed to be safer for the stomach, but have the same risk as other NSAIDs for kidney damage.
- Heartburn drugs of the proton pump inhibitor class, including omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazol (Rabecid, Aciphex), and esomeprazole (Nexium, Esotrex).
- Antiviral drugs, including acyclovir (Zovirax), used to treat herpes infection, and indinavir and tenofovir, both used to treat HIV.
- High blood pressure drugs, including captopril (Capoten).
- Rheumatoid arthritis drugs, including infliximab (Remicade), chloroquine, and hydroxychloroquine (the latter two are used to treat malaria and systemic lupus erythematosus, as well as rheumatoid arthritis).
- Lithium, used to treat bipolar disorder.
- Anticonvulsants, including phenytoin (brand name Dilantin) and trimethadione (brand name Tridione), used to treat seizures and other conditions.
- Chemotherapy drugs (including interferons, pamidronate, cisplatin, carboplatin, cyclosporine, tacrolimus, quinine, mitomycin C, bevacizumab) and antithyroid drugs (including propylthiouracil, used to treat overactive thyroid).
PROTON PUMP INHIBITORS DEPLETE MAGNESIUM
A 2016 study gives evidence that proton pump inhibitors (PPIs), used to treat heartburn, cause kidney injury.44 The authors echo my sentiments that any drug should only be used when necessary, not as a preventive measure. They say, “The results emphasize the importance of limiting PPI use to only when it is medically necessary, and also limiting the duration of use to the shortest period possible. A lot of patients start taking PPIs for a medical condition and they continue much longer than necessary.” Often doctors tell patients to keep taking drugs “just in case” their symptoms come back instead of instituting more natural measures to prevent recurrence of symptoms.
END-STAGE RENAL DISEASE
The number of patients enrolled in a Medicare-funded program to manage end-stage renal disease (ESRD) has increased from 10,000 in 1973 to a frightening 615,899 as of 2012.45 Medicine says they are at a loss to explain why so many people are affected. And despite the magnitude of the resources committed to the treatment of ESRD and assuming there have been improvements in the quality of dialysis therapy, these patients continue to experience significant mortality and morbidity and a reduced quality of life. If dialysis is taking over the function of the kidneys, then people should be feeling much better than they are. One reason for the escalation of symptoms could be magnesium deficiency that only gets worse with time because magnesium supplementation is avoided in dialysis patients and the amount of magnesium in their dialysate fluids is too low.
Signs of kidney disease include high blood pressure, protein on urinalysis, and an elevated glomerular filtration rate. High blood pressure is a very common cause of kidney disease. But in my opinion, the most common causes of high blood pressure are magnesium deficiency and calcium excess. Why else would doctors prescribe calcium channel blockers for high blood pressure if calcium was not a problem? Kidney patients are told to keep their blood pressure under control, but how are you going to do that if you are warned to stay away from magnesium? Instead you are told to take blood pressure medications that drain more magnesium.
Protein in the urine is one of the earliest signs of kidney disease, especially if you also have diabetes. One of the known medical signs of diabetes is a low magnesium level. So if you have kidney disease and you can’t take magnesium, your blood sugar levels are going to keep getting higher as your magnesium gets lower. And then you will be put on drugs for diabetes, which will cause more magnesium deficiency.
Doctors recommend kidney blood tests be done annually to help diagnose kidney disease early, so it can be treated. And what is the medical treatment? Using medications to prevent high blood pressure and diabetes. On all the medical websites I researched, there was no mention of using magnesium to prevent and treat high blood pressure or diabetes. These sites make it clear, however, that kidney disease is usually progressive, ending in kidney failure (end-stage renal disease) and heart failure. All the websites warn patients to avoid magnesium.
KIDNEYS NEED MAGNESIUM
I mentioned three kidney review papers in the Introduction that are opening the dialogue about magnesium and kidney disease. The first two reviews are from the Clinical Kidney Journal, February 2012 issue—“Magnesium in Disease” and “Magnesium Basics.”46, 47 In fact, there is a whole supplement section called “Magnesium—A Versatile and Often Overlooked Element: New Perspectives with a Focus on Chronic Kidney Disease,” devoted to magnesium in kidney disease.48 I’ll list the titles of the articles in that supplement to show the scope of the dialogue. Most articles are freely available on the Internet, so you can share them with your doctor. You may be surprised to learn that giving a few articles from a peer-reviewed journal to your doctor could make all the difference in his or her acceptance of magnesium therapy.
Articles in “Magnesium—A Versatile and Often Overlooked Element”
- Editorial: Whither Magnesium?
- Magnesium Basics
- Regulation of Magnesium Balance: Lessons Learned From Human Genetic Disease.
- Magnesium in Disease
- Magnesium in Chronic Kidney Disease Stages 3 and 4 and in Dialysis Patients
- Magnesium and Outcomes in Patients with Chronic Kidney Disease: Focus on Vascular Calcification, Atherosclerosis and Survival
- Use of Magnesium as a Drug in Chronic Kidney Disease
“Magnesium and Dialysis: The Neglected Cation” is a 2015 review where the authors found that magnesium requirements need to be reevaluated in the treatment of kidney disease and the use of magnesium in dialysis patients.49
There was a much earlier attempt to evaluate the need for magnesium in kidney disease, in 1993. Here is the story that opened my eyes to the importance of magnesium in kidney disease, a story told me by well-known magnesium researcher Dr. Burton Altura.
Many years ago Dr. Altura asked a colleague, a kidney disease specialist, Dr. Markell, to test his kidney patients for magnesium levels. It was agreed that both ionized magnesium and serum magnesium would be tested and compared in dialysis patients.50 The results were that people with chronic kidney disease (of all varieties) had simultaneously the highest levels of serum magnesium and the lowest levels of ionized magnesium. It appeared that their magnesium was stuck in the bloodstream and not getting into their cells. It’s not reported in the study, but when these patients took a liquid magnesium, their ionized magnesium levels improved, their serum magnesium levels became normal, their symptoms were alleviated, and their kidney function tests improved.
This anecdote explains for me why doctors fear magnesium. They just measure serum magnesium, see that the levels are elevated, and assume the worst. However, they don’t test for and therefore don’t notice that ionic magnesium is low, showing that the cells remain starved for magnesium. There is not enough magnesium in ionic form to get inside the cells to do its work. Unfortunately, the definitive test for magnesium, which measures ionized magnesium, is a re search tool and not available to the public. You can read more about magnesium testing in Chapter 16. Also read in Chapter 18 about the stabilized ionic form of magnesium, ReMag, that is the only form that I recommend for people with kidney disease.
MAGNESIUM DEFICIENCY IN END-STAGE RENAL DISEASE
The following is a case history that emphasizes what end-stage renal disease patients are up against in their battle to stay well. This insightful correspondence is from a Ph.D. in health sciences who suffers from ESRD. She describes the magnesium deficiency caused by her dialysis and her self-treatment with ReMag.
I am a sixty-year-old ESRD patient on home hemodialysis for four years. I am a type 1 diabetic as well. When I began dialysis I gave the nurse my list of supplements, which included magnesium, and I was told in no uncertain terms that dialysis patients should not and cannot take magnesium, our kidneys could be harmed by it. So I complied with their fearful stance as I entered into the unknown realms of kidney failure care, assuming they knew what they were talking about.
Before I began home hemodialysis I started off with peritoneal dialysis, since they presented it as the more “natural” mode. (Fluid is introduced through a permanent tube in the abdomen and flushed out the same tube during the night.) I soon developed incredible itching all over my body that they said was from being underdialyzed. But now I also believe that as my magnesium bottomed out, my calcium and phosphorus soared and combined to form calcium phosphate crystals, and who knows where else, which deposited in my skin. Dialysis people have lots of skin issues. Yes, they are due to toxins, but perhaps more importantly due to low magnesium.
I remember seeing things that looked like little white crystals in my skin, which I scratched until I bled. My own dialysis doctors were not even convinced this was due to dialysis! A nephrologist at Vanderbilt gave me a second opinion and had seen it. He said they call it the “crazy itch” and treat it by putting people under UV lights. Knowing what I do now, I presume the UV would be helpful by raising active vitamin D, which helps lower the calcium phosphate complex levels in the skin by sending the calcium and phosphorous into the bones.
I also began having horrendous nighttime calf and foot cramping on peritoneal dialysis, having to jump out of bed at night to try to soothe the unbearable pain. I was still afraid to take magnesium, so I downed vitamin E, B complex, etc., and whatever else I could find as suggestions online.
Then I was switched to home hemodialysis and there must be more magnesium in the dialysis solution they use compared to peritoneal dialysis because my skin improved. However, over a year ago I began to have heart palpitations that would at first come and go but then worsened and became more constant. After reading many recent studies online, I believe that the dialysis liquid they are putting in me is actually pulling magnesium out of my blood and depleting me. I feel my heart begin to palpitate in my chest towards the end of every treatment. Many patients have leg cramping during treatment. Many dialysis patients have heart issues; it’s the number one killer of dialysis patients, and most likely caused by magnesium deficiency.
During the four years since I have been on dialysis, I have broken bones in my feet three times; increased the level of calcification in my arteries (showed up on X-ray); had worsening palpitations, brain fog, and changes in my teeth; and who knows what else!
Thank goodness I found Dr. Dean’s ReMag and have been supplementing with it. I find it hard to believe but it totally resolves my palpitations. Of course I bump heads with the powers that be who say magnesium is dangerous for kidney patients, but my kidney specialist is finally behind my decision to use it.
Besides eliminating my palpitations, since I have been taking ReMag, my phosphorus levels have dropped to nearer normal levels so they are reducing the phosphate binders that I take with every meal. My hope is to reach a point where I need no binders at all. I have the hope that supplementing with ReMag will reverse many of my symptoms.
Magnesium is rarely measured in the dialysis setting. I went through all kinds of red tape to get pre-and posttreatment magnesium RBC blood testing. This should be routine! To me this is unbelievable because I’m sure most patients are having their magnesium sucked away through their dialysis treatment? And sure enough, my magnesium levels were lower after dialysis than before it. So each treatment depletes my magnesium further and further.
The more I look into magnesium deficiency, the more I attribute the majority of my health problems, since beginning dialysis, to the depletion of my magnesium levels. When I bring this up, the dialysis staff gets quite defensive. I seem to know more than they do, which intimidates them, not to mention that it really is the fault of their dialysis liquid that I have suffered these symptoms. They know so little about magnesium and how it interacts with phosphorus, calcium, PTH, and vitamin D3.
I just thank God I have found the studies online saying that I really do need magnesium and then I found ReMag, which really made such a difference, almost immediately. I sometimes wake up in the middle of the night with palpitations, and no way can I sleep with my heart bouncing around in my chest, so I pour a capful of ReMag in a few swallows of water, and I swear, within minutes my heartbeat returns to normal.
The 2015 review paper, “Magnesium and Dialysis: The Neglected Cation,” that I mentioned above and in the Introduction should provide kidney specialists with enough updated information to accept magnesium as a necessary mineral for kidney health.51 At the very least, it’s an article that you can print out and give to your doctor to explain why you want to take magnesium even if you have kidney disease.
NOTE: I only recommend ReMag to people with kidney disease because it is so well absorbed into the cells that it’s not going to build up to high levels in the blood.
VASCULAR CALCIFICATION IN KIDNEY DISEASE
Just as doctors are finding a buildup of calcium in the coronary arteries that they follow with coronary calcium scans to assess the risk of heart disease, vascular calcification is a sign of progressive kidney disease. A paper by Demer and Tintut in the journal Circulation discusses a complication of chronic kidney disease called vascular calcification that is causing widespread problems.52
The authors acknowledge the sad fact that most people over sixty years of age have “progressively enlarging deposits of calcium mineral in their major arteries.” The calcium buildup causes stiffness of the arteries, which results in hypertension, aortic stenosis, cardiac enlargement, angina, intermittent claudication of the lower legs, and congestive heart failure. They conclude, “The severity and extent of mineralization reflect atherosclerotic plaque burden and strongly and independently predict cardiovascular morbidity and mortality.”
I was shocked by the assertion in this paper that “progressively enlarging deposits of calcium mineral in their major arteries” is a fact of life in the over-sixty age group. Such a declaration goes hand in hand with the knowledge that most individuals over sixty have magnesium deficiency and the inability to keep calcium in solution!
Vascular calcification is gaining more recognition, but investigators are trying to distinguish it from atherosclerosis (hardening of the arteries), which is calcified fatty plaque that clogs up arteries. Personally, I think it’s just another theory that keeps researchers funded while ignoring the fact that calcium buildup in the arteries in any form is a serious health problem and magnesium is the solution.
A 2014 study did find that magnesium minimizes the buildup of vascular calcification by directly antagonizing phosphate and also by suppressing absorption of dietary phosphate.53 The investigators suggest that this action of magnesium allows it to act as a phosphate binder, which would be very helpful in dialysis patients who suffer excess phosphate levels. They do not mention the direct effects of magnesium on calcium—to keep it dissolved in solution in the body.
SUPPLEMENTS FOR KIDNEY DISEASE
- ReMag: With picometer, stabilized ionic magnesium you can reach therapeutic amounts without laxative effects. Start with . tsp (75 mg) and work up to 2 tsp (600 mg) per day. Add ReMag to a liter of water and sip all day to achieve full absorption.
- ReMyte: Picometer twelve-mineral solution. Take . tsp three times a day, or add 1. tsp to a liter of water with ReMag and sip throughout the day.
- ReAline: B vitamin complex plus amino acids. Take 1 capsule twice per day. Contains food-based B1 and four methylated B vitamins (B2, B6, methylfolate, and B12), plus L-methionine (precursor to glutathione) and L-taurine (which supports the heart and weight loss).
- Whole C ReSet: Whole C ReSet™ combines organic acerola, organic tart cherry and whole fruit complex. It provides full spectrum phytochemicals, polyphenols, including bioflavonoids, anthocyanins, proanthocyanins, ellagic acid, chlorogenic acid, resveratrol and quinic acid.* Barley seed powder derived from the RnA ReSet Drops makes it compatible with several other Completement Formulas.
- Vitamin D3: 1,000 IU or 20 minutes in the sun daily. Blue Ice Royal, from fermented cod liver oil and butter oil, for vitamins A, D, and K2, 1 capsule twice per day.