Magnesium Disorders Research Articles

A Comprehensive Review on Understanding Magnesium Disorders: Pathophysiology, Clinical Manifestations, and Management Strategies.

Magnesium is vital in a broad spectrum of physiological processes, including enzyme activity, energy production, and neuromuscular function. Despite its crucial role, magnesium disorders - comprising both deficiency (hypomagnesemia) and excess (hypermagnesemia) - are frequently underrecognized and inadequately managed in clinical practice. Magnesium deficiency is widespread, particularly among populations with chronic illnesses, the elderly, and those experiencing malnutrition, often leading to significant neuromuscular, cardiovascular, and metabolic complications. Conversely, hypermagnesemia, though less common, poses serious risks, especially in individuals with impaired renal function or those receiving high doses of magnesium supplements or medications. This review comprehensively examines magnesium disorders, detailing their pathophysiology, clinical manifestations, and management strategies. It highlights the essential functions of magnesium in maintaining cellular integrity, cardiovascular health, and bone structure and discusses the global prevalence and risk factors associated with magnesium imbalances. By offering insights into the current understanding of magnesium homeostasis and its disruptions, this review aims to enhance the awareness and treatment of magnesium-related conditions, ultimately improving patient outcomes across diverse clinical settings.

Serum magnesium level in peritoneal dialysis patients

Introduction: Electrolyte imbalances are common among dialysis patients, and disorders related to magnesium, calcium, and phosphorus are particularly concerning. However, comparatively less research is available on disorders related to magnesium ion disorders. Objectives: This paper aims to assess magnesium disorders in patients with renal failure undergoing peritoneal dialysis. Patients and Methods: In this cross-sectional study, we recruited patients who had been undergoing peritoneal dialysis for at least three months. We collected demographic information, body mass index (BMI), drug history, the underlying disease leading to renal failure, duration of dialysis, and serum magnesium level. Additionally, we measured levels of calcium, phosphorus, parathyroid hormone (PTH), albumin, and 25-hydroxyvitamin D. Results: A total of 91 patients were undergoing peritoneal dialysis, including 41.8% women and 58.2% men, with a mean magnesium level of 2.86±0.53 mg/dL. More than 70% of patients had hypermagnesemia and only one patient suffered from hypomagnesemia. Diabetic patients had a lower magnesium level than non-diabetics (P=0.01). Conclusion: Given the frequent occurrence of electrolyte imbalance in peritoneal dialysis, it may be necessary to regularly monitor electrolyte levels and make appropriate adjustments to both the patient’s diet and electrolyte levels.

Incidence of Dysmagnesemia among Medically Hospitalized Patients and Associated Clinical Characteristics: A Prospective Cohort Study.

Magnesium (Mg) disorders are common among hospitalized patients and are linked to poor health outcomes. We aimed to determine the incidence of dysmagnesemia among medically hospitalized patients and to identify factors that are associated with dysmagnesemia. A prospective cohort study was conducted at Sultan Qaboos University Hospital (SQUH) from April 1st, 2022, to October 31st, 2022, and involved hospitalized adult patients (≥18 years) under the care of the general internal medicine unit. The patients' serum total magnesium (Mg) concentrations were categorized as hypomagnesemia (≤0.69 mmol/L), hypermagnesemia (≥1.01 mmol/L), or dysmagnesemia, which encompassed either hypomagnesemia or hypermagnesemia. Of the 304 patients evaluated, dysmagnesemia was observed in 22.0%, which comprised of 17.4% with hypomagnesemia and 4.6% with hypermagnesemia. Statistically significant associations were identified between hypermagnesemia and chronic kidney disease (CKD) (p = 0.05) and elevated creatinine levels (p < 0.01) and lower estimated glomerular filtration rate (eGFR) (p < 0.01). Hypomagnesemia was linked to lower ionized calcium (p = 0.03) and admission due to infectious diseases (p = 0.02). However, ordered regression analysis did not find any significant associations with the different magnesium groups. Dysmagnesemia was prevalent among hospitalized patients and was associated with different factors; however, ordered regression analysis did not find any association with the different magnesium group, probably due to the limited number of included individuals.

Acute stroke in patients with diabetes mellitus: clinical physiology, diagnosis and course features

Diabetes mellitus is one of the risk factors for the development of acute stroke. The effects of stress hormones during an acute stroke can exacerbate diabetic ketoacidosis (DKA). There is a significant overlap of symptoms, signs, and laboratory test results in stroke and DKA, which often complicates accurate diagnosis and differential diagnosis of these conditions. The article discusses the features of the clinic, diagnosis and course of an acute stroke in patients with diabetes mellitus, and the authors’ own experience is given. It has been shown that patients with acute stroke with concomitant diabetes mellitus develop disorders of electrolyte metabolism, potassium, magnesium and phosphate balance, which require timely detection and correction. In order to accurately and timely diagnose DKA in all acute stroke patients suffering from diabetes, serum pH, bicarbonate, blood gases, and anion difference should be measured upon admission.

39-Year-Old Woman With Severe Weakness

39-Year-Old Woman With Severe Weakness

Plasma-Ionized Magnesium in Hospitalized Horses with Gastrointestinal Disorders and Systemic Inflammatory Response Syndrome.

Simple SummaryGastrointestinal diseases are the most prevalent diseases in hospitalized horses. One of the predisposing factors of decreased intestinal motility in horses with colic could be low plasma calcium concentration and related magnesium imbalances. Magnesium and calcium disturbances can predispose to decreased intestinal motility in horses with colic after abdominal surgery. Plasma ionized magnesium concentrations were measured in hospitalized horses with different types of gastrointestinal disorders (i.e., colic), horses with non-gastrointestinal diseases, horses with systemic inflammatory conditions and control horses; our results allowed us to conclude that hypomagnesemia was more prevalent in horses with obstructive gastrointestinal lesions. Surprisingly, no association was found with systemic inflammatory conditions nor with mortality. These valuable results suggest to us that magnesium concentrations in horses presenting obstructive colic should be monitored. Further research is needed to evaluate the effects of intravenous magnesium supplementation in horses with gastrointestinal diseases.Magnesium disorders in horses with gastrointestinal disorders or systemic inflammatory response syndrome (SIRS) are scarcely characterized. The purpose of the study was to explore the association of magnesium disorders with diagnosis, SIRS and mortality in horses admitted to a referral equine hospital. In total, 75 sick horses were included in an observational prospective study and classified as: obstructive (n = 17), inflammatory (n = 10) and ischemic gastrointestinal disorders (n = 12), and other non-gastrointestinal systemic disorders (n = 36). All sick horses were also divided according to the presence (n = 26) or absence of SIRS, and survival to discharge from hospital (survivors (n = 61) and non-survivors (n = 14). In addition, 26 horses were included as controls. On admission, mean (iMg) (95% confidence interval (CI)) in the SIRS group (0.47 (0.43–0.50 mmol/L)) was within the normal range (0.4–0.6 mmol/L). The obstructive group had lower (iMg) compared to the control group (0.44 (0.38–0.51 mmol/L) vs. 0.56 (0.50–0.61 mmol/L); p = 0.001). In total, 8 out of 17 (47%) horses with obstructive lesions presented with hypomagnesemia compared to controls (4% (1/26)) (p = 0.001). In conclusion, hypomagnesemia was more prevalent on admission in horses in the obstructive group, and to a lesser extent, in the inflammatory and ischemic groups. In contrast to human ICU patients, the proportion of hospitalized horses with hypomagnesemia was not associated with mortality.

MTOR-Activating Mutations in RRAGD Are Causative for Kidney Tubulopathy and Cardiomyopathy.

Over the last decade, advances in genetic techniques have resulted in the identification of rare hereditary disorders of renal magnesium and salt handling. Nevertheless, approximately 20% of all patients with tubulopathy lack a genetic diagnosis. We performed whole-exome and -genome sequencing of a patient cohort with a novel, inherited, salt-losing tubulopathy; hypomagnesemia; and dilated cardiomyopathy. We also conducted subsequent in vitro functional analyses of identified variants of RRAGD, a gene that encodes a small Rag guanosine triphosphatase (GTPase). In eight children from unrelated families with a tubulopathy characterized by hypomagnesemia, hypokalemia, salt wasting, and nephrocalcinosis, we identified heterozygous missense variants in RRAGD that mostly occurred de novo. Six of these patients also had dilated cardiomyopathy and three underwent heart transplantation. We identified a heterozygous variant in RRAGD that segregated with the phenotype in eight members of a large family with similar kidney manifestations. The GTPase RagD, encoded by RRAGD, plays a role in mediating amino acid signaling to the mechanistic target of rapamycin complex 1 (mTORC1). RagD expression along the mammalian nephron included the thick ascending limb and the distal convoluted tubule. The identified RRAGD variants were shown to induce a constitutive activation of mTOR signaling in vitro. Our findings establish a novel disease, which we call autosomal dominant kidney hypomagnesemia (ADKH-RRAGD), that combines an electrolyte-losing tubulopathy and dilated cardiomyopathy. The condition is caused by variants in the RRAGD gene, which encodes Rag GTPase D; these variants lead to an activation of mTOR signaling, suggesting a critical role of Rag GTPase D for renal electrolyte handling and cardiac function.

MTOR-activating mutations of RRAGD cause a novel syndrome combining kidney tubulopathy and cardiomyopathy

Advances in genetic techniques have resulted in the identification of rare inherited disorders of renal magnesium and salt handling. Nevertheless, ∼20% of all patients with primary kidney tubulopathy have no diagnosis. We explore a large multicentric cohort presenting with a novel inherited salt-losing tubulopathy mostly characterized by hypomagnesemia, combined with early-onset dilated cardiomyopathy (DCM). Whole exome and genome sequencings were performed with various subsequent functional analyses of identified RRAGD variants in vitro . In 8 children from unrelated families with a tubulopathy characterized by hypomagnesemia, hypokalemia, salt-wasting, and nephrocalcinosis, we identified heterozygous missense variants in RRAGD that mostly occurred de novo . Six of these patients additionally suffered from DCM, and a heart transplantation was performed in 3 of them before the age of 25y. A dominant variant in RRAGD was simultaneously identified in 8 members of a large family, which segregated with a similar renal magnesium-losing phenotype. No DCM was detected in this family. RRAGD encodes Rag GTPase D mediating amino acid signaling to the mechanistic target of rapamycin complex 1 (mTORC1). RagD expression along the mammalian nephron includes the thick ascending limb and the distal convoluted tubule. The identified RRAGD variants were shown to induce a constitutive activation of mTOR signaling in vitro . Our findings establish a novel diseased phenotype combining kidney tubulopathy and cardiomyopathy caused by an activation of mTOR signaling suggesting a critical role of Rag GTPase D for renal electrolyte handling and cardiac function.

Evaluation and Treatment of Disorders of Magnesium Balance

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.

SUN-343 Prevalence and Incidence of Hypomagnesemia and Hypermagnesemia in Medical Settings

Electrolytes disturbances are commonly observed in clinical practice. However, magnesium (Mg) disorders are often poorly considered. Our primary aim was to update the prevalence and the incidence of hypomagnesemia and hypermagnesemia in a real-life scenario. The secondary aim was to investigate the association of Mg disturbances with age and gender. Data from patients whose Mg serum levels were measured between January 2015 and December 2017 at our University Hospital were recorded. Hypomagnesemia was defined by Mg levels <1.5 mg/dL and hypermagnesemia by levels> 3.8 mg/dL. Hypo and hypermagnesemia cases were considered according to age, gender, year of observation and setting of subjects including outpatients and inpatients. In particular, inpatients were recruited from a total of 25 Hospital Divisions (i.e. Cardiology, Endocrinology, Geriatrics, Hematology, Intensive Care, Internal Medicine, Infectious Disease, Nephrology, Neonatal Intensive Care, Neurology, Neuropsychiatry, Neuroradiology, Oncology, Pulmonology, Pediatrics, Psychiatry, Rheumatology and Surgical Area that included 8 Units). Over the observation period, we recognized 12,696 patients whose Mg levels were checked. Prevalences of hypomagnesemia and hypermagnesemia were 8.43% (n=1071) and 1.78% (n=226) respectively. Hypomagnesemia was encountered more frequently in female [53.3% (n=560)] rather than in male patients [47.7 % (n=511)] (χ2= 4.03, p<0.045) and was significantly influenced by age: the higher prevalence of hypomagnesemia was found in patients over 65 yr. [59.01% (n=632)], whereas a lower prevalence was detected in the other age groups, specifically in 9.52 % (n=102) of patients aged 0-18 yr. and in 31.46 % (n=337) of patients between 19 and 65 yr. (χ2= 592.64; p<0.0001). Incidence of hypomagnesemia decreased over time with a borderline significance only in subjects over 65 yr. (r=-0.99; p=0.07). Geriatrics, Oncology and Intensive Care Division showed the highest incidences of hypomagnesemia. The hypermagnesemia prevalence was observed higher in outpatients in comparison with inpatients from any other Hospital Division and the hypermagnesemia incidence did not significantly change over time (r=0.96; p=0.16). Mg disorders, mainly hypomagnesemia, are quite common in clinical practice particularly in older hospitalized patients. Among the other electrolytes’ disturbances, Mg disorders, because of life-threatening significances, may be checked and corrected.

SUN-207 MAGNESIUM LEVELS IN DIABETIC PATIENTS WITH END STAGE RENAL DISEASE (ESRD) IN ONE CENTER IN THE UNITED ARAB EMIRATES (UAE)

Diabetic kidney disease is the primary aetiology of ESRD in the UAE1. Low magnesium has been associated with poor glycaemic control and complications including diabetic kidney disease2. Large cohort studies from Japan and the United States reported low mean serum magnesium among 1.6-20% of their dialysis population3,4. Lower magnesium level was found to be more prevalent in diabetic patient in the Japanese cohort. ESRD patients with low magnesium and low normal magnesium had higher cardiovascular and non-cardiovascular mortality3,4. Aim: To compare the prevalence of magnesium disorders among diabetic patients with ESRD and non-diabetic patients with ESRD. The study is a single centre cross sectional study that was conducted at Sheikh Khalifa Medical City (SKMC) dialysis centre in Abu Dhabi, UAE. Exclusion criteria included patients who do not regularly dialyse at our centre and those who had less than four readings of magnesium level during the study period. The study period was from January 2017 to December 2017. A total of 260 patients were included in the study. The majority (70%) of the patients were non Emirati nationals. 41% were females, and the mean age was 55 years. The mean magnesium among our patients was 0.98 mmol/L with a SD +/- 0.15. The normal reference range is 0.66-1.07 mmol/L (1.6-2.6 mg/dL). The 12 months mean magnesium readings were calculated for all the patients. None of our patients had a low average magnesium. 21.6% of our patients had high average magnesium levels, while 78.4% had normal average magnesium levels. 59% of Emirati patients compare to 40% of non-Emirati patients were diabetic. There was no statistically significant relationship between Magnesium level and DM status (0.14 respectively). None of our patients had an average low magnesium. There was no statistically significant difference between normal magnesium levels and being diabetic among dialysis patients in our centre.

Serum magnesium, mortality and disease progression in chronic kidney disease

IntroductionMagnesium disorders are commonly encountered in chronic kidney disease (CKD) and are typically a consequence of decreased kidney function or frequently prescribed medications such as diuretics and proton pump inhibitors. While hypomagnesemia has been linked with increased mortality, the association between elevated magnesium levels and mortality is not clearly defined. Additionally, associations between magnesium disorders, type of death, and CKD progression have not been reported. Therefore, we studied the associations between magnesium levels, CKD progression, mortality, and cause specific deaths in patients with CKD.MethodsUsing the Cleveland Clinic CKD registry, we identified 10,568 patients with estimated Glomerular Filtration Rate (eGFR) between 15 and 59 ml/min/1.73 m2 in this range for a minimum of 3 months with a measured magnesium level. We categorized subjects into 3 groups based on these magnesium levels (≤ 1.7, 1.7–2.6 and > 2.6 mg/dl) and applied cox regression modeling and competing risk models to identify associations with overall and cause-specific mortality. We also evaluated the association between magnesium level and slope of eGFR using mixed models.ResultsDuring a median follow-up of 3.7 years, 4656 (44%) patients died. After adjusting for relevant covariates, a magnesium level < 1.7 mg/dl (vs. 1.7–2.6 mg/dl) was associated with higher overall mortality (HR = 1.14, 95% CI: 1.04, 1.24), and with higher sub-distribution hazards for non-cardiovascular non-malignancy mortality (HR = 1.29, 95% CI: 1.12, 1.49). Magnesium levels > 2.6 mg/dl (vs. 1.7–2.6 mg/dl) was associated with a higher risk of all-cause death only (HR = 1.23, 95% CI: 1.03, 1.48). We found similar results when evaluating magnesium as a continuous measure. There were no significant differences in the slope of eGFR across all three magnesium groups (p = 0.10).ConclusionsIn patients with CKD stage 3 and 4, hypomagnesemia was associated with higher all-cause and non-cardiovascular non-malignancy mortality. Hypermagnesemia was associated with higher all-cause mortality. Neither hypo nor hypermagnesemia were associated with an increased risk of CKD progression.

PHOSPHORUS AND MAGNESIUM DISORDERS IN CRITICALLY ILL MECHANICALLY VENTILATED CHILDREN: THE PROSPECTIVE COHORT OBSERVATIONAL STUDY

Background. Phosphate and magnesium disorders frequently develop in critically ill patients during the course of stay in paediatric intensive care unit.Objectives. The aim of this study was to investigate the prevalence of hypophosphatemia and low level of magnesium in children with acute respiratory failure. The study hypothesis was that the duration of mechanical ventilation and stay in PICU in children depend on the presence of electrolyte disorders.Setting. Tertiary children`s hospital, Department of Anesthesiology and Intensive Care, Danylo Halytsky Lviv National Medical University; Department of Anesthesiology and Intensive Care, Lviv Regional Children Hospital “OCHMATDYT”, Ukraine, July 2018 - July 2019.Patients. Children aged 1 month - 1 year, who needed invasive mechanical ventilation.Intervention. Measurement levels of phosphorus and magnesium on 1st, 3rd, 5th and then every five days during mechanical ventilation.Main outcome measures. The primary outcome was the time to liberation from mechanical ventilation and secondary outcomes were complications: reintubation, tracheostomy, prolonged ventilation, or death.Results. We find out that 100% patients at admission had severe hypophosphatemia and 44% had low level of magnesium. Hypomagnesemia was treated until 10th day and level of phosphorus could not reach normal values until discharge. The presence of hypophosphatemia was associated with prolonged PICU admission (duration ratio 1.45, 95% CI 1.15 to 2.25), and a higher risk of complications (OR 1.72, 95% CI 1.15 to 2.52).Conclusion. The presence of hypophosphatemia in children who were mechanically ventilated due to acute respiratory failure was associated with prolonged PICU admission and a higher risk of complications.Trial registration: ISRCTN registry. Identifier: ISRCTN84734652.

Association of Hypocalcemia and Magnesium Disorders With Thyroidectomy in Commercially Insured Patients

Hypocalcemia is a common complication of total thyroidectomy. To identify factors associated with hypocalcemia after total thyroidectomy and to explore the association between hypocalcemia, magnesium disorders, and costs of care. A retrospective cross-sectional analysis was performed using data from the MarketScan Commercial Claim and Encounters database on 126 766 commercially insured patients younger than 65 years undergoing total thyroidectomy between January 1, 2010, and December 31, 2012. Statistical analysis was performed from January 1, 2016, to May 30, 2019. Short- and long-term hypocalcemia and the costs of care were examined using multivariable regression modeling. Among the 126 766 patients in the study (81.6% women; mean age, 46.5 years [range, 18-64 years]), postoperative hypocalcemia was present in 19.1% of patients in the initial 30-day postoperative period and in 4.4% of patients at 1 year. Magnesium disorders were present in 2.1% of patients at the time of surgery. Short- and long-term hypocalcemia were significantly more likely in women (short-term: odds ratio [OR], 1.39 [95% CI, 1.29-1.50]; long-term: OR, 1.69 [95% CI, 1.52-1.89]), those younger than 40 years (short-term: OR for ages 40-64 years, 0.83 [95% CI, 0.78-0.87]; long-term: OR for ages 40-64 years, 0.73 [95% CI, 0.67-0.79]), those with a diagnosis of thyroiditis (short-term: OR, 1.48 [95% CI, 1.16-1.89]; long-term: OR, 1.60 [95% CI, 1.13-2.26]) or cancer (short-term: OR, 1.32 [95% CI, 1.05-1.67]; long-term: OR, 1.17 [95% CI, 0.83-1.63]), vitamin D deficiency (short-term: OR, 1.96 [95% CI, 1.74-2.21]; long-term: OR, 3.72 [95% CI, 3.30-4.18]), concurrent lateral neck dissection (short-term: OR, 1.51 [95% CI, 1.37-1.66]; long-term: OR, 1.95 [95% CI, 1.69-2.26]), concurrent central neck dissection (short-term: OR, 1.15 [95% CI, 1.07-1.24]; long-term: OR, 1.25 [95% CI, 1.12-1.40]), intraoperative parathyroid (short-term: OR, 1.58 [95% CI, 1.46-1.71]; and long-term: OR, 2.05 [95% CI, 1.82-2.31]) or recurrent laryngeal nerve injury (short-term: OR, 1.49 [95% CI, 1.27-1.74]; long-term: OR, 2.04 [95% CI, 1.64-2.54]), and magnesium disorders (short-term: OR, 8.40 [95% CI, 7.21-9.79]; long-term: OR, 25.23 [95% CI, 19.80-32.17]). Compared with the initial postoperative period, the odds of hypocalcemia decreased by 90.0% (OR, 0.10 [95% CI, 0.09-0.11]) at 6 months and 93.0% (OR, 0.07 [95% CI, 0.06-0.08]) at 1 year. After controlling for all other variables, magnesium disorders were associated with the highest odds of short- and long-term postoperative hypocalcemia. Hypocalcemia ($3392) and magnesium disorders ($14 314) were associated with increased mean incremental 1-year costs of care. Hypocalcemia is common after total thyroidectomy but resolves in most patients by 1 year. Magnesium disorders are significantly independently associated with short- and long-term hypocalcemia and are associated with greater costs of care. These data suggest a potentially modifiable target to reduce the incidence and cost of long-term hypocalcemia at patient and systemic levels.

Total serum magnesium in cats with chronic kidney disease with nephrolithiasis.

Magnesium has been 'the forgotten ion' for many years. Over the past decade, however, the role of magnesium in essential physiological functions and several illness conditions have been elucidated. Nevertheless, the investigation of magnesium in cats with chronic kidney disease (CKD) and nephrolithiasis is yet to be determined. The purpose of this study was to investigate whether CKD cats with nephrolithiasis have changes in total serum magnesium concentrations, and whether magnesium disorders may be associated with other electrolyte disturbances, as well as with prognosis. We also aimed to evaluate whether total serum magnesium concentration differs between CKD cats with and without nephrolithiasis. Total serum magnesium concentrations were assessed in 42 cats with CKD with stage 1-4 nephrolithiasis. The correlation between magnesium and other electrolytes, as well as Kaplan-Meier survival analysis, were performed. We also selected 14 control cats with CKD without nephrolithiasis age-matched with 14 cats with CKD with nephrolithiasis. Hypermagnesemia was observed in 16/42 (38.1%) and hypomagnesemia in 6/42 (14.3%) cats. Serum magnesium abnormalities were observed in cats of all stages, and marked hypermagnesemia was noted in cats with stage 4 CKD with nephrolithiasis (P <0.001). There was a negative correlation between total serum magnesium and ionized calcium (r = -0.64; P <0.01), and a positive correlation between total serum magnesium and serum phosphorus (r = 0.58, P = 0.01). Cats with CKD with nephrolithiasis and hypomagnesemia or hypermagnesemia had higher mortality than those with normal total serum magnesium concentration (P <0.01), regardless of CKD stage. There was no difference in total serum magnesium concentration between CKD cats with and without nephrolithiasis. Cats with CKD with nephrolithiasis have magnesium abnormalities. Hypomagnesemia and hypermagnesemia were associated with an increase in mortality, and thus total serum magnesium abnormalities may be used as prognostic factors in these cases.

Magnesium disorders can cause calcium pyrophosphate deposition disease: A case report and literature review.

Calcium pyrophosphate deposition (CPPD) disease, also known as pseudogout, is one of the most common forms of inflammatory arthritis. A variety of comorbidities and metabolic conditions have been recognized to predispose to CPPD. We describe here a patient with chronic CPP arthritis due to hypomagnesemia, which is one of the metabolic etiologies associated with CPPD, especially in younger patients. We also performed a literature search and reviewed all reported cases of CPPD disease associated with hypomagnesemia. All cases of hypomagnesemia and its etiologies leading to CPP arthropathy identified in the literature by this systematic search are summarized in this paper.

Magnesium bei Hund und Katze – physiologische Aspekte, Messung und Störungen im Magnesiumhaushalt

Magnesium is the second most abundant intracellular cation after potassium. It plays a vital role in almost every metabolic process in the body and is important for bone mineralization, muscle contraction and relaxation, and neuronal signal transduction. Because of its expanding role in intensivecare medicine, there has been a significant increase in knowledge during recent years regarding the functions of magnesium in the body, problems leading to magnesium disorders, and limitations of laboratory testing. Alterations of serum magnesium constitute one of the most prevalent electrolyte abnormalities in critically ill patients and can lead to lifethreatening complications. In addition to human literature, most of the information regarding the role of magnesium is derived from buiatrics. In recent years, a few studies in veterinary medicine have also started to consider the importance of magnesium in dogs and cats.

Magnesium and Human Health: Perspectives and Research Directions.

Magnesium is the fourth most abundant cation in the body. It has several functions in the human body including its role as a cofactor for more than 300 enzymatic reactions. Several studies have shown that hypomagnesemia is a common electrolyte derangement in clinical setting especially in patients admitted to intensive care unit where it has been found to be associated with increase mortality and hospital stay. Hypomagnesemia can be caused by a wide range of inherited and acquired diseases. It can also be a side effect of several medications. Many studies have reported that reduced levels of magnesium are associated with a wide range of chronic diseases. Magnesium can play important therapeutic and preventive role in several conditions such as diabetes, osteoporosis, bronchial asthma, preeclampsia, migraine, and cardiovascular diseases. This review is aimed at comprehensively collating the current available published evidence and clinical correlates of magnesium disorders.

Діагностика та лікування водно-електролітних порушень у хворих на гострий інсульт на тлі супутнього цукрового діабету

The objective: to study the origin and characteristics of the flow of electrolyte abnormalities in patients with acute stroke (OR) on a background of concomitant diabetes mellitus (DM) and the possibility of their correction. Patients and methods. Electrolyte disturbances that occur in patients with acute stroke (AS) is one of the reasons complications of AS. Concomitant diabetes mellitus (DM) affects the severity of stroke and increased mortality rates. Analysis of 416 patients with the treatment of AS was conducted. All patients were divided into three groups: 1) patients with established diabetes before the stroke, 2) patients with newly diagnosed diabetes and 3) patients without diabetes. The second phase was conducted a pilot study with an analysis of the frequency of magnesium and phosphate metabolic disorders in the patients with AS (20 patients with AS on a background of diabetes and 10 stroke patients without diabetes). Results. In general, the different types of electrolyte disorders were observed in 73.9% patients with AS, while in patients with underlying disorders of carbohydrate metabolism, these violations occurred significantly more often than patients without such. In particular, carbohydrate metabolism occurred in 82 (81.2%) and 36 (83.7%) patients 1 and 2 groups versus 134 (65.4%) in the control group (p&lt;0.05). Hypomagnesemia (less than 0.8 mmol/L) was observed in 2 of 10 patients (20%) in AS without carbohydrate disturbances and in 6 of 20 patients (30%) in AS with concomitant diabetes. Hypophosphatemia (phosphate levels less than 0,8 mmol/L) was found in patients without diabetes and AS in 2 patients with concomitant DM or newly diagnosed diabetes. Following the correction of oral medication containing phosphates and magnesium blood electrolyte levels was stabilized and that coincided with the improvement of the patients and the degree of disability. Conclusion: Electrolyte disorders are fairly common problem in patients with concomitant diabetes and AS. In patients with impaired carbohydrate metabolism observed significantly higher frequency (more than 81,2% of patients) occurrence of electrolyte disorders than patients without them. Conclusion. In the case of AS on a background of diabetes electrolyte disturbances occur significantly more frequently than in patients without such comorbid disorders. Key words: stroke, electrolytes, sodium, potassium, chloride, magnesium, phosphate.

Association between Magnesium Disorders and Hypocalcemia following Thyroidectomy.

To identify factors associated with postoperative hypocalcemia after thyroid surgery and to understand the relationship among hypocalcemia, length of hospitalization, and costs of care. Retrospective database analysis. Discharge data from the Nationwide Inpatient Sample for 620,744 patients who underwent thyroid surgery from 2001 to 2010 were analyzed through cross-tabulations and multivariate regression modeling. Hypocalcemia, length of stay, and costs were examined as dependent variables. Secondary independent variables included magnesium and phosphate metabolism disorders, vitamin D deficiency, menopause, sex, extent of surgery, malignancy, and surgeon volume. Hypocalcemia was reported in 6% of patients and was significantly more common for the following variables: women, age <65 years, patients from the Northeast, total thyroidectomy ± neck dissection patients, low-volume surgical care, malignancy, recurrent laryngeal nerve injury, and patients with disorders of magnesium or phosphate metabolism (P < .001). Magnesium and phosphate disorders were present in <1% of patients. Magnesium disorders were significantly more likely for patients with hypocalcemia (7%; P < .001), and hypocalcemia was present in 52% of patients with magnesium disorders (P < .001). On multiple logistic regression analysis, the odds of hypocalcemia were greatest for patients with magnesium disorders (odds ratio, 12.71; 95% confidence interval, 8.59-18.82). This relationship was not attenuated by high-volume surgical care. Hypocalcemia and magnesium disorders were both associated with increased length of stay and costs, with a greater effect for magnesium disorders than for hypocalcemia (P < .001). Disorders of magnesium metabolism are an independent risk factor for postthyroidectomy hypocalcemia and are associated with significantly increased costs and length of stay.