Hypermagnesemia 1059585 207595552 2008-04-23T13:06:28Z Arcadian 104523 clean up - nav, Replaced: {{Metabolic pathology}} → {{Mineral metabolic pathology}} using [[Project:AutoWikiBrowser|AWB]] {{Infobox_Disease | Name = {{PAGENAME}} | Image = Mg-TableImage.png | Caption = [[Magnesium]] | DiseasesDB = 6259 | ICD10 = {{ICD10|E|83|4|e|70}} | ICD9 = {{ICD9|275.2}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 3383| eMedicine_mult = {{eMedicine2|emerg|262}} {{eMedicine2|ped|1080}} | MeshID = | }} '''Hypermagnesemia''' is an [[electrolyte disturbance]] in which there is an abnormally elevated level of [[magnesium]] in the blood. Usually this results in excess of magnesium in the body. Hypermagnesemia occurs rarely because the [[kidney]] is very effective in excreting excess magnesium. It usually develops only in people with kidney failure who are given magnesium salts or who take drugs that contain magnesium (e.g. some [[antacid]]s and [[laxative]]s). It is usually concurrent with [[hypercalcemia]] and/or [[hyperkalemia]]. ==Metabolism== For a detailed description of magnesium [[homeostasis]] and [[metabolism]] see [[hypomagnesemia]]. ==Symptoms== * Weakness, nausea and vomiting * Impaired breathing * [[Hypotension]] * [[Hypocalcemia]] * [[Arrhythmia]] and [[Asystole]] Though Arrhythmia and Asystole are possible cardiac outcomes of Hypermagnesemia, most cardiac symptoms are due to conduction delays, since magnesium acts as physiologic [[Calcium channel blocker|calcium blocker]]. Clinical consequences related to serumconcentration: *4.0 mEq/l [[hyporeflexia]] *>5.0 mEq/l Prolonged atrioventricular conduction *>10.0 mEq/l Complete [[heart block]] *>13.0 mEq/l [[Cardiac arrest]] ==Causes== Since magnesium is excreted through the [[kidney]]s, [[renal failure]] (as a result of hypermagnesemia) most often occurs due to prolonged over supplementation or long term use of magnesium containing medications or laxatives. ===Predisposing conditions=== *[[Hemolysis]], magnesium concentration in erythrocytes is approximately three times greater than in serum, therefore hemolysis can increase plasma magnesium. Hypermagnesemia is expected only in massive hemolysis. *[[Renal insufficiency]], excretion of magnesium becomes impaired when [[creatinine clearance]] falls below 30 ml/min. However, hypermagnesemia is not a prominent feature of renal insufficiency unless magnesium intake is increased. *Other conditions that can predispose to mild hypermagnesemia are [[diabetic ketoacidosis]], [[adrenal insufficiency]], [[hyperparathyroidism]] and [[lithium]] [[intoxication]]. ==Therapy== Prevention of hypermagnesemia usually is possible. In mild cases, withdrawing magnesium suppletion is often sufficient. In more severe cases the following treatments are used: * [[Intravenous]] [[calcium gluconate]], because the actions of [[magnesium]] in [[neuromuscular]] and [[cardiac]] function are antagonized by [[calcium]]. Definitive treatment of hypermagnesemia requires increasing renal magnesium excretion through: * Intravenous [[diuretic]]s, in the presence of normal [[renal function]] * [[Dialysis]], when kidney function is impaired and the patient is symptomatic from hypermagnesemia {{Mineral metabolic pathology}} [[Category:Electrolyte disturbances]] [[Category:Magnesium]] [[Category:Nephrology]]