Skip to main content
British Medical Journal logoLink to British Medical Journal
. 1972 Sep 9;3(5827):620–622. doi: 10.1136/bmj.3.5827.620

Magnesium Deficiency in Patients on Long-Term Diuretic Therapy for Heart Failure

Pin Lim, Edward Jacob
PMCID: PMC1785918  PMID: 5071700

Abstract

Magnesium levels in serum, erythrocytes, skeletal muscle, and bone were measured in 10 patients with valvular heart disease who had received diuretic therapy for heart failure for an average of 3·3 years. Five patients were found to have diminished values for skeletal muscle, indicating significant magnesium deficit. Values for erythrocytes were low in only two of the five patients, and none had low values for serum ultrafiltrate and bone: Magnesium replacement therapy restored skeletal muscle values to normal. Clinical features consistent with the presence of magnesium deficiency were found in all five magnesium-deficient patients. These features were, with few exceptions, corrected by magnesium replacement. The latter also corrected low skeletal muscle potassium values present in all five patients with low skeletal muscle magnesium, four of whom showed clinical features of digoxin poisoning before magnesium therapy was given. Concomitant secondary aldosteronism, inadequate dietary intake, and digoxin therapy had probably augmented the magnesium loss due to diuretic therapy.

Full text

PDF
620

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARKER E. S., ELKINTON J. R., CLARK J. K. Studies of the renal excretion of magnesium in man. J Clin Invest. 1959 Oct;38:1733–1745. doi: 10.1172/JCI103952. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BARNES B. A., COPE O., HARRISON T. Magnesium conservation in the human being on a low magnesium diet. J Clin Invest. 1958 Mar;37(3):430–440. doi: 10.1172/JCI103623. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. FOURMAN P., MORGAN D. B. Chronic magnesium deficiency. Proc Nutr Soc. 1962;21:34–41. doi: 10.1079/pns19620008. [DOI] [PubMed] [Google Scholar]
  4. HORTON R., BIGLIERI E. G. Effect of aldosterone on the metabolism of magnesium. J Clin Endocrinol Metab. 1962 Dec;22:1187–1192. doi: 10.1210/jcem-22-12-1187. [DOI] [PubMed] [Google Scholar]
  5. Jacob E., Lim P., Khoo O. T. Serum ionized calcium level in chronic renal failure. Med J Aust. 1969 Jun 7;1(23):1172–1174. doi: 10.5694/j.1326-5377.1969.tb62252.x. [DOI] [PubMed] [Google Scholar]
  6. KUPFER S., KOSOVSKY J. D. EFFECTS OF CARDIAC GLYCOSIDES ON RENAL TUBULAR TRANSPORT OF CALCIUM, MAGNESIUM, INORGANIC PHOSPHATE, AND GLUCOSE IN THE DOG. J Clin Invest. 1965 Jul;44:1132–1143. doi: 10.1172/JCI105220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lim P., Jacob E., Dong S., Khoo O. T. Values for tissue magnesium as a guide in detecting magnesium deficiency. J Clin Pathol. 1969 Jul;22(4):417–421. doi: 10.1136/jcp.22.4.417. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. MACINTYRE I., DAVIDSSON D. The production of secondary potassium depletion, sodium retention, nephrocalcinosis and hypercalcaemia by magnesium deficiency. Biochem J. 1958 Nov;70(3):456–462. doi: 10.1042/bj0700456. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. MARTIN H. E., MEHL J., WERTMAN M. Clinical studies of magnesium metabolism. Med Clin North Am. 1952 Jul;21:1157–1171. [PubMed] [Google Scholar]
  10. MONTGOMERY R. D. Magnesium metabolism in infantile protein malnutrition. Lancet. 1960 Jul 9;2(7141):74–76. doi: 10.1016/s0140-6736(60)91217-4. [DOI] [PubMed] [Google Scholar]
  11. Parfitt A. M. The acute effects of mersalyl, chlorothiazide and mannitol on the renal excretion of calcium and other ions in man. Clin Sci. 1969 Apr;36(2):267–282. [PubMed] [Google Scholar]
  12. SINGER B., WENER J. Excretion of sodium-retaining substances in patients with congestive heart failure. Am Heart J. 1953 Jun;45(6):795–801. doi: 10.1016/0002-8703(53)90127-6. [DOI] [PubMed] [Google Scholar]
  13. WHANG R., WELT L. G. Observations in experimental magnesium depletion. J Clin Invest. 1963 Mar;42:305–313. doi: 10.1172/JCI104717. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. WILLIAMS J. A., NICHOLSON G. I. A modified bone-biopsy drill for outpatient use. Lancet. 1963 Jun 29;1(7296):1408–1408. doi: 10.1016/s0140-6736(63)92059-2. [DOI] [PubMed] [Google Scholar]
  15. WOLFF H. P., KOCZOREK K. R., BUCHBORN E. Hyperaldosteronism in heart disease. Lancet. 1957 Jul 13;273(6985):63–66. doi: 10.1016/s0140-6736(57)92543-6. [DOI] [PubMed] [Google Scholar]
  16. Wacker W. E., Parisi A. F. Magnesium metabolism. N Engl J Med. 1968 Apr 4;278(14):772–concl. doi: 10.1056/NEJM196804042781406. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES