Renal Magnesium Wasting Disorders

  • John H. Dirks
  • Norman L. M. Wong
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 208)


Hypomagnesemia and magnesium deficiency may be due to gastrointestinal malabsorption, poor dietary intake or renal (tubular) magnesium wasting. Magnesium wasting would result in hypomagnesemia if dietary magnesium intake is insufficient. A number of causes of magnesium wasting have been identified including congenital or primary renal magnesium wasting, hyperaldosteronism, Bartter’s syndrome, diabetic ketoacidosis, acute alcohol intake and hypercalcemia with hypercalcuria. More recently attention has focussed on renal magnesium wasting due to drugs including diuretics, antibiotics, chemotherapeutic and immunosuppressive agents. One can consider renal magnesium wasting as an exaggerated physiological response due to pharmacological or toxic impairment of normal tubular magnesium reabsorption. It is clear that the ensuing hypomagnesemia is dependent on the dietary magnesium intake and the overall cellular magnesium depletion does not necessarily occur in a predictable fashion.


Proximal Tubule Loop Diuretic Magnesium Transport Magnesium Excretion Osmotic Diuretic 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    G. A. Quamne and J. H. Dirks, Magnesium: Cellular and Renal Exchanges, in “The Kidney, Physiology and Pathophysiology.” D. W. Seldin and G. Giebisch, ed., Raven Press, New York (1985).Google Scholar
  2. 2.
    G. R. Shareghi and Z. S. Agus, Magnesium transport in the cortical thick ascending limb of Henle’s loop of the rabbit. J. Clin. Invest. 69: 759 (1982).CrossRefGoogle Scholar
  3. 3.
    G. A. Quamme, Effect of hypercalcenia on renal tubular handling of calcium and magnesium. Can. J. Physiol. Pharmacol. 60: 1275 (1982).CrossRefGoogle Scholar
  4. 4.
    G. R. Shareghi and Z. S. Agus, PTH - Sensitive magnesium transport in the rabbit cortical thick ascending limb of Henle. (CTAL) Kidney Int. 16:S37A (1979).Google Scholar
  5. 5.
    N. L. M. Wong, G. A. Quamme, and J. H. Dirks, Influence of Bicarbonate on the Renal Handling of Magnesium, in: “Urolithiasis, Clinical and Basic Research.” L. H. Smith, W. G. Robertson, and B. Finleyson, ed., Plenum Press, New York (1984).Google Scholar
  6. 6.
    N. L. M. Wong, G. A. Quamme, R. A. L. Sutton, and T. O’Callaghan, Renal and tubular transport in phosphate depletion: A micropuncture study. Can. J. Physiol. Pharmacol. 58: 1063 (1980).CrossRefGoogle Scholar
  7. 7.
    J. Seeha.m and A. White, Diuretic associated hypomagneseuria. Br. Med. J. 285: 1157 (1982).CrossRefGoogle Scholar
  8. 8.
    P. 0. Wester and T. Dyckner, Diuretic treatment and magnesium losses. Acta Medica. Scand. 647 (Suppl.): 145 (1981).Google Scholar
  9. 9.
    G. A. Quamme, Effect of furosemide on calcium and magnesium transport in the rat nephron. Am. J. Physiol. 241: 340 (1981).Google Scholar
  10. 10.
    N. L. M. Wong, G. A. Quamme, R. A. L. Sutton, and J. H. Dirks, Effect of mannitol on water and electrolyte transport in the dog kidney. J. Lab. and Clin. Med. 94: 683 (1979).Google Scholar
  11. 11.
    E. S. Barker, J. R. Elkinton, and J. K. Clark, Studies in the renal excretion of magnesium in man. J. of Clin. Invest. 38: 1733 (1959).CrossRefGoogle Scholar
  12. 12.
    N. L. M. Wong, G. A. Quamme, and J. H. Dirks, Effect of chlorothiazide on renal calcium and magnesium handling in the hamster. Can. J. Physiol. Pharmacol. 60: 1160 (1980).CrossRefGoogle Scholar
  13. 13.
    J. Devane and M. P. Ryan, Evidence for a magnesium-sparing action by amiloride during renal clearance studies in rats. Br. J. of Pharmacol. 78: 891 (1983).Google Scholar
  14. 14.
    R. L. Schilsky, A. Barlock, and R. F. Ozols, Persistent hypomagnesemia following cisplatin chemotherapy for testicular cancer. Cancer Treat. Reports 66: 1767 (1982).Google Scholar
  15. 15.
    C. G. D. Brook, Hypomagnesemia, hypocalcemia with hypokalemia caused by treatment with high dose gentamycin. Arch. Dis. Child. 53: 817 (1978).CrossRefGoogle Scholar
  16. 16.
    C. B. Thompson, C. H. June, K. M. Sullivan, and E. D. Thomas, Association between cyclosporin neurotoxicity and hypomagnesemia. Lancet. 2 (8412): 1116 (1984).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  • John H. Dirks
    • 1
    • 2
  • Norman L. M. Wong
    • 1
    • 2
  1. 1.Dept. of MedicineUniversity of British ColumbiaVancouverCanada
  2. 2.Acute Care UnitHealth Sciences Centre Hospital VancouverCanada

Personalised recommendations