The Diuretic-Magnesium Question in Heart Failure

  • L. Alcocer
  • A. J. Reyes


Magnesium deficit must be prevented and treated with particular zeast in chronic congestive heart failure. Besides its usual general consequences, in the case of chronic congestive heart failure under chronic therapy with loop or thiazide-type diuretics magnesium deficit predisposes to (digitalis-induced or not) cardiac arrhythmias, causes resistance to potassium replenishment in patients with hypokalemia, could impair cardiac pump function directly at the cardiac level, and could facilitate (exaggerate) vasoconstriction.

Loop and thiazide-type diuretics increase the renal excretion of magnesium and may conduce to magnesium deficit upon prolonged administration; this possibility is enhanced by the coexistence of factors other than diuretic therapy which may concur to the development of this condition. However, the use of diuretics is mandatory in chronic congestive heart failure. Copharmacotherapy with potassium-retaining diuretics should not be instituted as a routine. Oral magnesium suplementation, correction of concomitant factors conducing to magnesium deficit, and the use of appropriate doses of diuretics appear as the best measures to prevent and/or treat diuretic-induced deficit in patients with chronic congestive heart failure and normal renal function..


Congestive Heart Failure Loop Diuretic Serum Magnesium Chronic Congestive Heart Failure Serum Magnesium Concentration 
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Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • L. Alcocer
    • 1
  • A. J. Reyes
    • 2
  1. 1.National University of Mexico and Mexico City General HospitalTuxpanMexico
  2. 2.Institute of Cardiovascular TheoryMontevideoUruguay

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