Hypomagnesemia: renal magnesium handling

Semin Nephrol. 1998 Jan;18(1):58-73.


Magnesium is an important constituent of the intracellular space that affects a number of intracellular and whole body functions. Magnesium balance depends on intake and renal excretion, which is regulated mainly in the thick ascending limb of the loop of Henle. The complex hormonal modulation that responds to changes in plasma concentration of other ions such as calcium and potassium is lacking for magnesium. As a result, negative magnesium balance results in a prompt decrease in plasma magnesium concentration, and hypermagnesemia accompanies renal failure with magnesium accumulation. Hypomagnesemia may result from gastrointestinal losses or renal losses, the latter due to primary renal magnesium wasting or in association with sodium loss. Hypomagnesemia may arise together with and contribute to the persistence of hypokalemia and hypocalcemia. The major direct toxicity of hypomagnesemia is cardiovascular. When urgent correction of hypomagnesemia is required, as with myocardial ischemia, post cardiopulmonary bypass, and torsades de pointes, intravenous or intramuscular magnesium sulfate should be used. Oral magnesium preparations are available for chronic use.

Publication types

  • Review

MeSH terms

  • Animals
  • Biological Transport / physiology
  • Clinical Trials as Topic
  • Heart Diseases / complications
  • Heart Diseases / drug therapy
  • Humans
  • Intracellular Fluid / metabolism
  • Kidney / metabolism*
  • Magnesium / blood*
  • Magnesium Deficiency / complications
  • Magnesium Deficiency / diagnosis
  • Magnesium Deficiency / drug therapy
  • Magnesium Deficiency / metabolism*
  • Magnesium Deficiency / physiopathology
  • Magnesium Sulfate / therapeutic use
  • Water-Electrolyte Imbalance / drug therapy
  • Water-Electrolyte Imbalance / etiology


  • Magnesium Sulfate
  • Magnesium