Altered serum levels of FGF-23 and magnesium are independent risk factors for an increased albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease.

Abstract Aims To investigate the role of FGF-23 and magnesium in relation to the albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease (CKD) stages 2–4. Methods In a cross-sectional study we included all eligible type 2 diabetic patients with CKD stages 2–4, followed in our outpatient Diabetic Kidney clinic. We used descriptive statistics, the Student's t-test, ANOVA and the chi-square tests. Our population was divided according to the UACR (G1 30−300 mg/g and G2 ≥ 300 mg/g), and compared these groups regarding several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors of increased UACR. Results The patients in G2 displayed a lower eGFR (p = 0.0001) and, had lower levels of magnesium (p = 0.004) as well as higher levels of FGF-23 (p = 0.043) compared to patients in G1. FGF-23 (β = 0.562, P = 0.0001) and the magnesium (β = − 8.916, p = 0.0001) were associated with increased UACR. Conclusions A dysregulation of mineral metabolism, reflected by altered levels of magnesium and FGF-23, correlates with an increased UACR in type 2 diabetic patients with CKD stages 2–4.