Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • 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 ++Whang R. Clinical disorders of magnesium metabolism. Compr Ther. 1997;23:168. [PubMed: 9113454] ++Onishi S. Yoshino S. Cathartic-induced fatal hypermagnesemia in the elderly. Internal Medicine. 2006, 45(4):207-10. [PubMed: 16543690] Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.