Hypermagnesemia | Preventive Measures | Endocrinology


What is hypermagnesemia?

Hypermagnesemia is rare and happens when too much magnesium circulates in the blood. In healthy people, very slight magnesium circulates in the blood. The gastrointestinal (intestine) and renal (kidney) systems regulate and control the amount of magnesium that the body absorbs from food and the amount that is excreted in the urine.

These systems control the amount of magnesium that the body absorbs from food and the amount that is excreted in the urine. A healthy body upholds a level of 1.7 to 2.3 milligrams per deciliter (mg / dL) of magnesium at all times. A high magnesium level is 2.6 mg / dL or more.

Causes of hypermagnesemia

The efficacy of the renal response to a magnesium load is such that hypermagnesemia is observed mainly in two situations: when renal function is impaired and/or when a large magnesium load is administered, either intravenously, orally, or as an enema.

Renal failure: Hypermagnesemia can be seen in 10 to 15 per cent of hospitalized patients, usually in the setting of kidney failure. Plasma magnesium levels increase as renal function declines since there is no magnesium regulatory system other than urinary excretion.

The typical patient with end-stage renal disease (ESRD), for example, has a plasma magnesium concentration of 2 to 3 mEq / L (2.4 to 3.6 mg / dL or 1 to 1.5 mmol / L). In dialysis patients, the plasma magnesium concentration is mainly determined by the intake of magnesium. This was demonstrated in a cross-sectional study of hemodialysis patients who completed a dietary questionnaire; the correlation between estimated dietary magnesium intake and serum magnesium was 0.87.

Furthermore, hypermagnesemia (defined as serum magnesium greater than 1.5 mmol / L) occurred with magnesium intakes as low as 281 mg/day, which is considerably lower than the average intake in the general population. Symptomatic and severe hypermagnesemia can also be induced when exogenous magnesium is administered as antacids or laxatives in the usual therapeutic doses. As a result, these drugs are contraindicated in patients with renal failure.

Hypermagnesemia symptoms

You may not have any symptoms if your blood magnesium levels are significantly elevated. You may have muscle weakness, misperception, and decreased reactions if your blood test results show severely high blood magnesium levels.

Things you can do for hypermagnesemia:

  • Follow your healthcare provider’s orders regarding lowering your blood magnesium level. If your blood levels are severely high, he or she may prescribe medications to lower the levels to a safe range.
  • Take all of your medicines as directed if blood test fallouts show you have hypermagnesemia. Avoid laxatives and antacids covering magnesium if your kidneys are not working properly.

If you are constipated:

  • Make sure to keep active, and keep your bowels moving!
  • Increase your daily intake of fresh fruit and fibre. Prunes and prune juice may work for some of those. It is important to move your bowels daily.
  • If you do not move your bowels every day, your health care provider may prescribe stool softeners and laxatives to help prevent constipation, not containing magnesium if you have kidney problems. Work with your healthcare provider to mature a regimen that will work for you.

Drink 2 to 3 litres of fluid every 24 hours, unless you were told to restrict your fluid intake. This will decrease your chances of being dehydrated, which can lead to constipation.

Track all of your healthcare provider’s references for follow up blood work and laboratory tests. Evade caffeine and alcohol, as these can cause you to have electrolyte disturbances.

Drugs that may be set by your physician for hypermagnesemia:

  • Calcium: This medication is given typically intravenously, to lower the blood magnesium level, if you have severely high blood magnesium levels.
  • Hemodialysis: If you have a harshly elevated blood magnesium level, and you are currently in kidney failure, your healthcare breadwinner and a kidney specialist may order dialysis treatments.

Diagnosis of hypermagnesemia

Serum magnesium concentrations> 2.6 mg / dL (> 1.05 mmol / L). At serum magnesium concentrations of 6 to 12 mg / dL (2.5 to 5 mmol / L), the ECG shows a prolongation of the PR interval, a widening of the QRS complex, and increased amplitude of the T wave.

Deep tendon reactions disappear when the serum magnesium attentiveness approaches 12 mg / dL (5.0 mmol / L); hypotension, respiratory depression, and narcosis develop with increased hypermagnesemia. Cardiac arrest can occur when the magnesium concentration in the blood is> 15 mg / dL (6.0 to 7.5 mmol / L).

Hypermagnesemia treatment

Treatment of severe magnesium toxicity consists of circulatory and respiratory support and administration of calcium gluconate 10%, 10-20 ml IV. Calcium gluconate can reverse many of the changes induced by magnesium, including respiratory depression. IV furosemide administration can increase magnesium excretion when renal function is adequate; the volume state must be maintained.

Hemodialysis can be of worth in severe hypermagnesemia because a comparatively large fraction (about 70%) of magnesium in the blood is not protein-bound and therefore can be removed by hemodialysis. When hemodynamic compromise occurs and hemodialysis is impractical, peritoneal dialysis is an option.

Prevention of hypermagnesemia

People with underlying kidney problems are at risk of developing hypermagnesemia because their kidneys may not be able to excrete enough magnesium. Avoiding medications that contain magnesium can help prevent complications. This includes some over-the-counter antacids and laxatives. Clinicians are advised to test for hypermagnesemia in anyone with poorly performing kidneys experiencing the associated symptoms.

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