Abstract: Magnesium is an ion with important physiological and biochemical effects. The serum magnesium of hemodialysis patients with endstage kidney disease is affected by residual renal function, dialysis clearance, drug and nutritional status.Hypermagnesemia is common but rarely accompanied by clinical symptoms,well hypomagnesemia is associated with increased hypotension, arrhythmia, muscle spasm, cardiovascular mortality, and all-cause mortality in hemodialysis patients. Mild hypermagnesemia can improve the parathyroid hormone level, vascular calcification and bone health of hemodialysis patients to a certain extent. Proton pump inhibitors, high-dose loop diuretics and malnutrition can reduce the serum magnesium concentration. It is safe and convenient to use dialysate with higher magnesium concentration to supplement. Magnesium is related to the survival status and prognosis of dialysis patients. Although it is not clear whether the relationship between magnesium and the clinical outcome of dialysis patients is causal, serum magnesium slightly higher than the physiological level seems to benefit patients more. It is necessary to further study metabalism of magnesium in hemodialysis patients to explore whether there is an optimal range of serum magnesium, so as to optimize the bone health, cardiovascular outcomes and survival rate of patients.

Key words: end-stage kidney disease, hypomagnesemia, hemodialysis, dialysate, chronic kidney disease-mineral bone disorder