Renal System >
Hypermagnesaemia

Electrolyte disturbance characterised by serum magnesium levels > 1.05mmol/L

Risk Factors
  • AKI
  • CKD
  • Lithium therapy
  • Hypothyroidism
  • Addison’s disease
Aetiology
  • Commonly secondary to renal failure and administration of magnesium-containing drugs such as antacids and laxatives
Pathophysiology
  • Renal impairment leads to decreased magnesium excretion
Clinical Presentation
  • Hypotension
  • Respiratory depression
  • Cardiac arrest
  • Hyporeflexia
Investigations
  • Bloods:
    • Serum magnesium concentration
  • Imaging: n/a
  • Special:
    • ECG – shows prolonged PR interval, wide QRS complexes and peaked T waves
Management
  • IV administration of calcium gluconate and a diuretic such as furosemide or dialysis
Complications
  • Severe hypotension
  • Cardiac arrhythmia
  • Neurological disorder such as confusion
  • Severe hypermagnesemia can lead to cardiorespiratory arrest and coma

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