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.
Its homeostasis involves dietary intake, absorption, uptake and release from bone, swifts between the intra- and extracellular compartment, and renal excretion. Renal excretion is mainly responsible for regulation of magnesium balance.
The causes of magnesium deficiency include: Chronic diarrhea. Frequent vomiting. Malabsorption, due to a digestive condition, such as inflammatory bowel disease (IBD), or a procedure that removes part of the small intestine, namely weight loss surgery.
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.
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. Magnesium is needed for many functions in the body. This includes the physical and chemical processes in the body that convert or use energy (metabolism).
Diseases causing malabsorption such as celiac disease and inflammatory bowel disease. Gastric bypass surgery. Hereditary syndromes causing poor absorption of magnesium (primary intestinal hypomagnesemia). Medications which can cause interference with magnesium absorption (proton pump inhibitors such as omeprazole).
Mg is required for metabolism of vitamin D in the liver and the kidneys and also for its transportation in serum. Helps in the reabsorption of Mg in the kidney, absorption in the gut, and release from the bone.
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 is commonly associated with liver diseases, and may result from low nutrient uptake, greater urinary secretion, low serum albumin concentration, or hormone inactivation.
Very low magnesium levels may cause:
Headaches. Nighttime leg cramps. Numbness or tingling in the legs or hands. General body weakness.
In this study, the prevalence of hypomagnesemia was significantly higher in patients who did not recover kidney function.
Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy characterized by renal potassium wasting, hypokalemia, metabolic alkalosis, hypocalciuria, hypomagnesemia, and hyperreninemic hyperaldosteronism. [1] Gitelman syndrome is also referred to as familial hypokalemia-hypomagnesemia.
Urine Tests
One of the earliest signs of kidney disease is when protein leaks into your urine (called proteinuria). To check for protein in your urine, a doctor will order a urine test.
Protein in the urine is an early sign that the kidneys' filters have been damaged, allowing protein to leak into the urine. This puffiness around your eyes can be due to the fact that your kidneys are leaking a large amount of protein in the urine, rather than keeping it in the body. Your ankles and feet are swollen.
Magnesium deficiency is common among people with alcohol use disorder (AUD), gastrointestinal (GI) diseases, and type 2 diabetes.
Magnesium is mainly absorbed in the small intestine [21, 15, 46], although some is also taken up via the large intestine [7, 10, 47].
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.
Hypokalemia and Hyperkalemia
Magnesium depletion typically occurs after diuretic use, sustained alcohol consumption, or diabetic ketoacidosis.
One study found that very high doses of zinc from supplements (142 mg/day) can interfere with magnesium absorption and disrupt the magnesium balance in the body [17].
Hypomagnesemia occurs with both loop diuretics (furosemide, bumetanide, torsemide, and ethacrynic acid) and thiazide diuretics (chlorothiazide, hydrochlorothiazide, indapamide, and metolazone).