Evaluation and Treatment of Disorders of Magnesium Balance

Abstract

Disorders of magnesium are reasonably prevalent, yet under-identified. We review how the kidney and gastrointestinal tract maintain normal magnesium homeostasis and the contexts and illness that may disrupt magnesium balance. We also suggest an approach to the evaluation, diagnosis, and management of magnesium disorders, with an emphasis on genetic etiologies that have helped to elucidate normal renal homeostatic functions and reveal mechanisms of disease. Research is ongoing and continues to reveal new mechanisms of gastrointestinal and renal magnesium transport and regulation. We discuss some of the more recently identified genetic mechanisms of renal magnesium wasting and dysregulation. Magnesium is an essential cation, needed for hundreds of cellular functions. Magnesium disorders may be due to either altered intake or gastrointestinal magnesium absorption or impairment of renal tubular magnesium handling. Recognizing the symptoms, risks, and co-morbidities for disorders of magnesium may help identify, diagnose, and manage groups of patients with increased hospital morbidity and mortality. Research continues to explore and clarify our understanding of mechanisms for the regulation of the total body and plasma magnesium. Additional clinical research is needed to link therapy and treatment goals with clinical outcomes.