Abstract: 【Abstract】Objective To investigate the association between serum magnesium and cardiovascular and cerebrovascular events and all-cause mortality in maintenance hemodialysis (MHD) patients. Methods The clinical data of patients who underwent hMHD in Yijishan Hospital of Wannan Medical College from June 1, 2017 to December 30, 2020 were collected. Patients were divided into 3 groups according to the tertiles of mean serum magnesium. The differences of clinical data were compared among the three groups. COX regression was used to determine the factors influencing the mortality in MHD patients. Results In the 384 MHD
patients, 135 patients in the low magnesium group (Mg≤0.98 mmol/L), 120 patients in the normal magnesium group (Mg 0.98～1.1 mmol/L)，129 patients in the high magnesium group (Mg≥1.1 mmol/L). The prevalence of cardiovascular and cerebrovascular diseases and the proportion of cardiovascular and cerebrovascular mortality were significantly different among the three groups (Z=6.506, P=0.039; Z=9.348 P=0.009); Log-Rank test showed that cardiovascular and cerebrovascular mortality was statistically significant (Log-rank c2=8.313, P=0.016) among the three groups. The univariate COX regression analysis showed that serum magnesium and hypermagnesemia (Mg>0.98mmol/L) were the protective factors for cardiovascular and cerebrovascular mortality
(HR=0.060, 95% CI: 0.005～0.703, P=0.025; HR=0.421, 95% CI: 0.220~0.807, P=0.009), but the COX regression after adjusting for many mixed factors showed that hypomagnesemia is not an independent risk factor for cardiovascular and cerebrovascular mortality (HR=1.066，95% CI: 0.339～3.352，P=0.912). Conclusion The cardiovascular and cerebrovascular mortality in MHD patients with hypomagnesemia is higher than the other two groups, but it may not be an independent risk factor.

Key words: Maintenance hemodialysis, Werum magnesium, Cardiovascular and cerebrovascular mortality