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Fatal hypermagnesemia.

J R Schelling¹

¹MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44109-1998, USA.

Clinical Nephrology

|February 8, 2000

Summary

Severe hypermagnesemia is a rare but serious condition, often caused by magnesium intake in patients with kidney failure. This case highlights the critical need to assess renal function before administering magnesium, especially in high doses.

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Area of Science:

Nephrology
Cardiology
Toxicology

Background:

Severe symptomatic hypermagnesemia is a rare clinical issue.
It predominantly occurs in patients with renal failure due to excess exogenous magnesium intake.
Elderly patients with unrecognized acute renal failure are particularly vulnerable.

Observation:

An elderly woman received a magnesium-containing cathartic for pre-operative bowel preparation.
She had unrecognized acute renal failure, leading to severe hypermagnesemia.
This resulted in one of the highest reported serum magnesium concentrations.

Findings:

The patient developed junctional bradycardia, myocardial infarction, and respiratory failure.
Continuous arteriovenous hemodialysis was used for treatment.
Despite treatment, the patient died from hypermagnesemia complications.

Implications:

Ensuring intact renal function is crucial before administering oral magnesium.
Large doses of magnesium salts should be avoided in patients with acute renal failure.
This case underscores the risks associated with magnesium administration in renal impairment.

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