Hypomagnesemia
Definition
- Serum Mg++ <1.8 mg/dL
Etiology:
- Malnutrition (assc. with heavy chronic alcohol use causing renal wasting)
- Malabsorption or diarrhea/GI loss
- PPI induced
- Renal losses (polyuria and high tubular flow, e.g., osmotic diuresis, post-ATN diuresis)
- Hypercalcemia (e.g. hyperparathyroidism)
- Loop and thiazide diuretic associated
- Proximal tubular toxins (e.g. aminoglycosides, amphotericin, cisplatin)
- Calcineurin inhibitors (tacrolimus > cyclosporine)
- Volume expansion (reduced Mg++ reabsorption due to reduced Na and H2O reabsorption)
- Gitleman and Bartter syndromes
- Uncontrolled DM, post-parathyroidectomy (Hungry bone syndrome)
Evaluation:
- Order CMP, serum Mg++ and Phosphorus level
- Review patient history, clinical circumstances, nutritional status and medications
Management: