Introduction
Magnesium has been used since ancient times as a purgative and uterine relaxant. We obtained excellent results in a selected group of hypokalemic patients with impaired renal function by constantly monitoring serum levels of magnesium and creatinine. The results were unexpectedly encouraging and prompted us to use magnesium on these types of patients more often.
Selection criteria
Severe hypokalemia (K < 3); baseline urine output 5 ml/kg per hour and more; serum creatinine 2–5. Anuric and chronic renal failure patients were excluded from this study.
Methods
Five grams of magnesium is administered in D5W over 8 hours for a period spanning up to five consecutive days monitoring parameters such as urine output, creatinine, serum magnesium/potassium, deep tendon reflexes and patient outcome.
Results
Total patients, n = 55 (Fig. 1 and Table 1).
Figure 1.
Table 1.
| Conditions | n | Serum K before Mg | Serum K after Mg | Creatinine before Mg | Creatinine after Mg | Urine output before Mg (ml/kg per hour) | Urine output after Mg (ml/kg per hour) |
|---|---|---|---|---|---|---|---|
| Dehydration | 25 | 1.5–3 | 4.5–5 | 1.4–5 | 0.8–1.4–1.6 | 0.5–1 | 1–3 |
| CHF/LVF | 16 | 2.5–3 | 3.6–4.5 | 2–7 | 1–1.5 | 0.5–1 | 1–2 |
| Refractory hypokalemia K | 14 | 2–3 | 4–4.5 | 0.8–1.2 | 0.8–1.2 | 1 | 1–3 |
Conclusions
Magnesium was given to treat hypokalemia refractory and otherwise; patients responded very well.
Urine output increased substantially, through indirect diuretic action of magnesium. Substantial decrease in the creatinine in selected patients; an event quite unexplainable and contrary to conventional wisdom, probably another salutary action of magnesium, more work is needed on this aspect. Reduction in creatinine could not be achieved in septic/septic shock patients.