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, Volume 28, Supplement 1, pp 161–166 | Cite as

Intracellular Magnesium Loss After Diuretic Administration

  • Thomas Dyckner
  • P. O. Wester
Section 2: Mechanism and Physiological Significance of Electrolyte Disturbances

Summary

Diuretic agents influence the renal handling of magnesium, causing increased losses of the ion. Continuing magnesium losses may, in the long term, result in a magnesium deficiency. 296 patients with congestive heart failure or arterial hypertension receiving long term diuretic therapy were studied by skeletal muscle biopsies to assess their magnesium status. 65% of the congestive heart failure patients and 42% of the patients with arterial hypertension were found to have subnormal values for skeletal muscle magnesium.

Studies with the potassium-sparing diuretics amiloride, spironolactone and triamterene demonstrate that these drugs significantly increase the muscle magnesium content in patients on long term diuretic treatment for congestive heart failure and/or arterial hypertension — in addition to their well known positive effect on potassium balance.

Keywords

Spironolactone Amiloride Diuretic Therapy Triamterene Magnesium Deficiency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Les diurétiques agissent sur le métabolisme rénal du magnésium en accroissant son élimination. A long terme, la fuite rénale de magnésium peut avoir des conséquences cliniques. Chez 296 malades souffrant d’insuffisance cardiaque congestive ou d’hypertension artérielle et qui recevaient des diurétiques en traitement au long cours, on a pratiqué des biopsies musculaires pour y mesurer la concentration en magnésium. On a trouvé des valeurs proches de la normale chez 65% des insuffisants cardiaques et chez 42% des hypertendus.

Dans le cadre de ces 2 pathologies, des études comparant des diurétiques d’épargne du potassium utilisés au long cours, amiloride, spironolactone et triamtérène, ont montré qu’ils augmentent significativement la concentration en magnésium au niveau musculaire. Ceci s’ajoute à leur effet déjà connu d’épargne du potassium.

Zusammenfassung

Diuretika beeinflussen die renale Behandlung von Magnesium und verursachen erhöhte Verluste dieses Ions. Kontinuierliche Magnesiumverluste können über längere Zeit einen Magnesiummangel ergeben. 296 Patienten mit Herzinsuffizienz oder arterieller Hypertonie, die eine diuretische Langzeittherapie erhielten, wurden mittels Skelettmuskelbiopsien untersucht, um ihren Magnesiumstatus zu bestimmen. Bei 65% der Patienten mit Herzinsuffizienz und bei 42% der Patienten mit arterieller Hypertonie wurden subnormale Magnesium werte für den Skelettmuskel gefunden.

Untersuchungen mit den Kalium-sparenden Diuretika Amilorid, Spironolacton und Triamteren ergaben, daβ diese Pharmaka den Magnesiumgehalt des Muskels bei Patienten unter einer diureüschen Langzeittherapie wegen Herzinsuffizienz und/oder arterieller Hypertonie signifikant erhöhten — neben ihrer wohlbekannten positiven Wirkung auf die Kaliumbilanz.

Sommario

I diuretici influenzano il rimaneggiamento renale del magnesio, determinando maggiori perdite di questo ione. Una perdita continua di magnesio puó, a lungo termine, condurre ad una carenza di magnesio. Sono stati studiati 296 pazienti affetti da scompenso cardiaco congestizio o da ipertensione arteriosa, che ricevevano una terapia diuretica a lungo termine. Nello studio si è fatto uso di biopsie muscolari scheletriche allo scopo di valutare il loro patrimonio in magnesio. Si trovò che il 65% dei pazienti con scompenso cardiaco congestizio ed il 42% di quellt con ipertensione arteriosa presentavano concentrazioni di magnesio nella muscolatura scheletrica inferior! al normale.

Studi eseguiti con diuretici risparmiatori di potassio quali amiloride, spironolattone e triamterene, dimostrano che questi farmaci aumentano in modo significativo il contenuto muscolare di magnesio in pazienti in terapia cronica con diuretici per scompenso cardiaco congestizio e/o per ipertensione arteriosa — oltre al loro ben noto effetto positivo sul bilancio del potassio.

Resumen

Los diuréticos influyen sobre el modo en que el riñón maneja el magnesio, dando lugar a mayores pérdidas del mismo. Las pérdidas continuadas de este ión pueden acabar a la larga en déficit del mismo. Se estudiaron 296 patientes afectos de insuficiencia cardiaca congestiva (ICC) o hipertensión arterial y sometidos a tratamiento diurético a largo plazo, mediante biopsias de müsculo esquelético para determinar su estado en lo relativo al magnesio, comprobándose que el 65% de los patientes con ICC y el 42% de los de hipertensión arterial presentaban valores subnormales de magnesio en el müsculo esquelético.

Los estudios realizados con los diuréticos ahorradores de potasio (amilorida, espironolactona y triamterena) han demostrado que estos compuestos aumentan significativamente el contenido muscular de magnesio en los patientes sometidos a tratamiento diurético prolongado para la ICC y/o hipertension, además de sus beneficiosos efectos, ya conocidos, sobre et balance de potasio.

Resumo

Os agentes diuréticos influenciam o tratamento que os rins dão ao magnésio, causando perdas aumentadas do ion. Perdas continuadas de magnésio podem, a longo-prazo, resultar em deficiência de magnésio. Foram estudados 296 patientes com deficiência cardiaca congestiva ou com hipertensão arterial em tratamento de longa duração à base de diuréticos, por meio de biópsias do músculo esthado, com o objetivo de determinar-se o seu estado em relação à repleção de magnesio. Verificou-se valores sub-normais para a concentração de magnésio no músculo estriado em 65% dos patientes com deficiência cardiaca congestiva e em 42% dos patientes com hipertensao arterial.

Há estudos com os diuréticos amiloride, spironolactone e triamterene — poupadores de potássio — demonstrando que estas drogas aumentam sensivelmente a concentração de magnésio no músculo em patientes de deficiência cardiaca congestiva ou de hipertensão arterial, sob tratamento de longa duração à base de diuréticos, além de demonstrarem o seu bem conhecido efeito positivo sobre o equilibrio do potássio.

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Copyright information

© ADIS Press Limited 1984

Authors and Affiliations

  • Thomas Dyckner
    • 1
  • P. O. Wester
    • 1
  1. 1.Department of Internal MedicineUniversity of UmeåUmeåSweden

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