biostudies-literatureUnknown12Dial-Mag Investigator Writing Committee*<h4>Background</h4>In individuals receiving hemodialysis, lower serum magnesium concentrations are associated with a higher risk of death and cardiovascular disease and more discomfort from muscle cramps. Small trials suggest that increasing serum magnesium by using a higher concentration of dialysate magnesium may be beneficial. This protocol outlines a large, randomized trial examining the effects of adopting a high versus low concentration of dialysate magnesium as a hemodialysis center-wide policy on the risk of mortality, major adverse cardiovascular events, and the burden of muscle cramps.<h4>Objective</h4>To determine whether implementing a dialysate magnesium concentration of 0.75 mmol/L versus ≤ 0.5 mmol/L as a hemodialysis center-wide policy, for up to 4 years, affects (1) the raCanadian journal of kidney health and disease20543581251385011https://www.ebi.ac.uk/biostudies/studies/S-EPMC12696322biostudies-literatureOutcomes of Adopting a Higher Versus Lower Concentration of Hemodialysate Magnesium as a Center-Wide Policy (Dial-Mag): A Clinical Research Protocol of a Pragmatic, Registry-Based, Cluster Randomized Trial.PMC12696322Shah NTonelli MBrown PADev VKumar Kolusu ELacson EDhruve MGregor LPerkins DSontrop JMVorster HDial-Mag Investigator Writing Committee*Kammila SChan CTShulman TTangri NGarg AXMolnar AOYao SBerry DHiremath SZacharias JParmar MSWalters JCowan ACWhitlock RHBohm CNathoo BLouis ISBeaubien EAntonsen JAnderson SWadehra DBDay NEMazurat AAl-Jaishi AASteele ADjurdjev OKiaii MKillin LCuerden MSBagga ABlake PGSilver SASingh AQuinn KWald ROliver MJRomann ALuo BThompson SNistico AAcedillo RRBueti JHarris CPandeya SSasal JCote BJoseph GTing RHMacRae JMfalseOutcomes of Adopting a Higher Versus Lower Concentration of Hemodialysate Magnesium as a Center-Wide Policy (Dial-Mag): A Clinical Research Protocol of a Pragmatic, Registry-Based, Cluster Randomized Trial.<h4>Background</h4>In individuals receiving hemodialysis, lower serum magnesium concentrations are associated with a higher risk of death and cardiovascular disease and more discomfort from muscle cramps. Small trials suggest that increasing serum magnesium by using a higher concentration of dialysate magnesium may be beneficial. This protocol outlines a large, randomized trial examining the effects of adopting a high versus low concentration of dialysate magnesium as a hemodialysis center-wide policy on the risk of mortality, major adverse cardiovascular events, and the burden of muscle cramps.<h4>Objective</h4>To determine whether implementing a dialysate magnesium concentration of 0.75 mmol/L versus ≤ 0.5 mmol/L as a hemodialysis center-wide policy, for up to 4 years, affects (1) the ra2025-01-01T00:00:00Z20252026-06-06T03:46:52.962Z2026-05-25T03:11:28.509ZS-EPMC126963224139327310.1177/20543581251385011