Hypermagnesemia

• • Renal insufficiency

  • Elevated serum magnesium

Epidemiology

• • Usually occurs in patients with renal disease

  • Rare in surgical patients

Symptoms and Signs

• • Lethargy

  • Weakness

  • Widened QRS complex

  • Depressed ST segment

  • Peaked T waves

• • When serum level reaches 6 mEq/L, deep tendon reflexes are lost

  • Levels > 10 mEq/L can lead to somnolence, coma, and death

• • Magnesium should be carefully monitored in patients with renal insufficiency

  • Serum levels

  • ECG

• • IV isotonic saline to increase renal excretion

  • Slow IV infusion of calcium

  • Dialysis may be necessary

Medications

• • Isotonic saline infusion

  • Calcium gluconate infusion

Treatment Monitoring

• • ECG monitoring

  • Serum magnesium levels

Prognosis

• • Excellent if treated

Prevention

• • Regulation of magnesium intake in patients with renal insufficiency

References