Introduction. Magnesium 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.
In chronic kidney disease (CKD), an increase in fractional magnesium excretion compensates for declining glomerular filtration rate (GFR) in such a way that plasma magnesium concentrations can be maintained in the normal range for a long time with unchanged dietary intake [10].
Magnesium supplements can cause excessive accumulation of magnesium in the blood, especially with patients who have chronic kidney disease. Accumulation of magnesium in the blood can cause muscle weakness, but does not damage the kidney directly.
The kidney plays a major role in regulating the Mg balance. In a healthy individual, total-body Mg content is kept constant by interactions among intestine, bones and the kidneys. Summary: In case of chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal Mg absorption.
Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline.
Regulation of magnesium transport in the kidney occurs primarily in the TAL and DCT. In the TAL, both magnesium and calcium can activate the calcium-sensing receptor (CaSR) on the basolateral membrane and modulate paracellular magnesium transport 58.
Magnesium deficiency in healthy people is rare but it can be caused by: a poor diet (especially in elderly people or those who don't have enough to eat) type 2 diabetes. digestive problems such as Crohn's disease.
The calcium antagonistic effect of magnesium is also important for reducing the risk of kidney stones, and silent kidney stones significantly increase the risk of kidney failure. As low magnesium intake will reduce the urinary magnesium concentration, the beneficial effect of magnesium on stone formation is hampered.
Every organ in the body, especially the heart, muscles, and kidneys, needs the mineral magnesium. It also contributes to the makeup of teeth and bones.
You might have trouble absorbing magnesium from food if you drink too much alcohol, have kidney problems, take certain medicines, or have celiac disease or long-lasting digestive problems. If you are low on magnesium for a long time and it becomes magnesium deficiency, which is rare, you may have: Poor appetite.
One of the biggest factors is the presence of calcium in the diet, as high calcium foods can reduce your magnesium absorption (and vice versa). Foods containing sugar and caffeine may have similar effects.
Magnesium—just like calcium—is absorbed in the gut and stored in bone mineral, and excess magnesium is excreted by the kidneys and the faeces (Figure 4). Magnesium is mainly absorbed in the small intestine [21, 15, 46], although some is also taken up via the large intestine [7, 10, 47].
Magnesium status is closely linked with liver function. Liver diseases have a significant effect on body magnesium content, and magnesium levels in turn influence these disease processes.
The levels are regulated primarily in the kidney at the level of renal tubular reabsorption. Instead, control seems to be as fluxes at the intestine, kidney, intracellular fluids and perhaps the skeleton. The kidney is the prime regulator of serum Mg concentration.
Hypokalemia and Hyperkalemia
Magnesium depletion typically occurs after diuretic use, sustained alcohol consumption, or diabetic ketoacidosis.
Hypomagnesemia is an electrolyte disturbance caused by a low serum magnesium level (less than 1.46 mg/dL) in the blood. Hypomagnesemia can be attributed to chronic disease, alcohol use disorder, gastrointestinal losses, renal losses, and other conditions.
Thus, the elderly population is especially at risk of magnesium deficiency due to low intake but also increased risk for chronic diseases that predispose to magnesium deficiency (ageing also reduces magnesium absorption from the diet, ie, achlorhydria).
Chronic magnesium deficiency is often associated with normal serum magnesium despite deficiency in cells and in bone; the response to oral supplementation is slow and may take up to 40 weeks to reach a steady state.
"The people at highest risk for low magnesium are those with diarrhea and other forms of malabsorption," like Crohn's disease and celiac disease, says Dr.
Untreated magnesium deficiency can, over time, increase the risk of: High blood pressure. Type 2 diabetes. Heart disease.
Personality changes, including apathy, depression, agitation, confusion, anxiety, and delirium are observed when there is a deficiency of this element. Rodents receiving a diet deficient in magnesium displayed depressive behaviour that was reversed by antidepressant drugs.