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Salivary Magnesium as a Biomarker in Kidney Transplant Recipients Receiving Tacrolimus: A Cross-Sectional Study with Serum–Saliva Correlation Analysis
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Rezvan Ghanavati1   , Mohammad Javad Saidi1 , Taiebeh Mohammadi Farsani2 |
1- Isfahan (Khurasgan)
2- Department of Medical Biotechnology, Isf.C., Islamic Azad University, Iran , Taiebeh.mohammadi@iau.ac.ir |
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Abstract: (15 Views) |
Abstract
Background and Objective: Tacrolimus remains the pivotal immunosuppressant in kidney transplantation, yet its propensity to enhance renal magnesium wasting predisposes recipients to hypomagnesemia with potentially severe clinical sequelae. Conventional monitoring of serum magnesium is invasive and resource‑intensive, whereas saliva represents a non‑invasive biofluid with promise as a surrogate biomarker. This study aimed to delineate the correlation between salivary and serum magnesium concentrations in kidney transplant recipients receiving tacrolimus across distinct post‑transplant intervals.
Methods: this cross‑sectional study, 100 adult kidney transplant recipients receiving tacrolimus were enrolled. Blood and saliva samples were collected at four predefined post‑transplant time points (week 1, month 1, month 3, and month 6). Unstimulated saliva (5 mL) was centrifuged at 3000 rpm for 10 minutes and stored at 4 °C. Serum and salivary magnesium concentrations were quantified using a standardized Pars Azmoon kit and a colorimetric spectrophotometric method (λ = 532 nm). Reliability and validity were confirmed according to international standards. Statistical analyses were performed using paired t‑tests, one‑way ANOVA, and Pearson’s correlation coefficient (SPSS v26, GraphPad Prism v9), with significance set at p < 0.05.
Results: The incidence of hypomagnesemia peaked at 52% during the third month post‑transplant. Mean serum magnesium declined from 2.03 mg/dL in the first week to 1.84 mg/dL at month three, while salivary magnesium decreased from 0.145 mmol/L to 0.108 mmol/L. A significant correlation was observed only at week one (r = 0.392, p = 0.008), with saliva demonstrating acceptable diagnostic accuracy for hypomagnesemia exclusively at this time point (AUC = 0.781, p = 0.006). No statistically significant differences in magnesium levels were detected between sexes. These findings suggest that salivary magnesium may serve as a provisional surrogate for serum measurement in the early post‑transplant period; however, in later phases, the correlation weakens and diagnostic performance diminishes. Larger studies with extended follow‑up, rigorous drug control, and comprehensive patient physiology assessment are warranted to validate this approach.
Conclusion: This study demonstrates that salivary magnesium may serve as an approximate biomarker for serum magnesium levels in the early post‑transplant period. However, in later phases, the correlation weakens and diagnostic accuracy declines. Accordingly, clinical validation of this approach requires future investigations with larger cohorts, stricter pharmacological control, and exploration of additional salivary biomarkers |
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| Keywords: Tacrolimus, Kidney Transplant Recipients, Saliva, Serum Magnesium, Hypomagnesemia, Biomarker |
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Type of Study: Applicable |
Subject:
Dentistry
Received: 2025/07/30 | Accepted: 2025/12/23 | Published: 2025/12/24
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