Hypokalemia, magnesium and high creatinine

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

Table 1

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.