Volume 7 Supplement 2

23rd International Symposium on Intensive Care and Emergency Medicine

Open Access

Hypokalemia, magnesium and high creatinine

  • A Aaron1,
  • MM Bahadur2,
  • A Bachwani3,
  • KM Mody1,
  • DM Gamadia1,
  • CB Wadia1,
  • BS Pardiwadia1,
  • JD Sunavala1,
  • BB Ichhaporia1,
  • SA Golwalla1,
  • JA Chichgar1 and
  • CB Kohiar1
Critical Care20037(Suppl 2):P224

https://doi.org/10.1186/cc2113

Published: 3 March 2003

Introduction

Magnesium has been used since ancient times as a purgative and uterine relaxant. We obtained excellent results in a selected group of hypokalemic patients with impaired renal function by constantly monitoring serum levels of magnesium and creatinine. The results were unexpectedly encouraging and prompted us to use magnesium on these types of patients more often.

Selection criteria

Severe hypokalemia (K < 3); baseline urine output 5 ml/kg per hour and more; serum creatinine 2–5. Anuric and chronic renal failure patients were excluded from this study.

Methods

Five grams of magnesium is administered in D5W over 8 hours for a period spanning up to five consecutive days monitoring parameters such as urine output, creatinine, serum magnesium/potassium, deep tendon reflexes and patient outcome.

Results

Total patients, n = 55 (Fig. 1 and Table 1).

Figure 1

Conditions

n

Serum K before Mg

Serum K after Mg

Creatinine before Mg

Creatinine after Mg

Urine output before Mg (ml/kg per hour)

Urine output after Mg (ml/kg per hour)

Dehydration

25

1.5–3

4.5–5

1.4–5

0.8–1.4–1.6

0.5–1

1–3

CHF/LVF

16

2.5–3

3.6–4.5

2–7

1–1.5

0.5–1

1–2

Refractory hypokalemia K

14

2–3

4–4.5

0.8–1.2

0.8–1.2

1

1–3

Conclusions

Magnesium was given to treat hypokalemia refractory and otherwise; patients responded very well.

Urine output increased substantially, through indirect diuretic action of magnesium. Substantial decrease in the creatinine in selected patients; an event quite unexplainable and contrary to conventional wisdom, probably another salutary action of magnesium, more work is needed on this aspect. Reduction in creatinine could not be achieved in septic/septic shock patients.

Authors’ Affiliations

(1)
Intensive Care Unit, Parsee General Hospital
(2)
BAM Railway Hospital
(3)
BARC Hospital

Copyright

© BioMed Central Ltd 2003

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