[Review: UPDATE on magnesium metabolism].

Area of Science:

• Nephrology
• Internal Medicine
• Clinical Pharmacology

Background:

• Magnesium is a crucial intracellular cation, vital for numerous bodily functions.
• Low magnesium levels are linked to various conditions, including insulin resistance, type-2 diabetes, asthma, osteoporosis, and chronic kidney disease (CKD).
• Proton pump inhibitors (PPIs) are a leading cause of hypomagnesemia.

Purpose of the Study:

• To review the mechanisms underlying PPI-induced hypomagnesemia.
• To examine the impact of hypomagnesemia on patients with CKD.
• To discuss the synergistic effect of PPIs and diuretics on magnesium levels in CKD.

Main Methods:

• Literature review focusing on hypomagnesemia mechanisms.
• Analysis of studies investigating the relationship between PPIs, diuretics, and magnesium levels.
• Examination of the physiological effects of electrolyte disturbances in CKD.

Main Results:

• PPIs disrupt magnesium absorption, leading to hypomagnesemia.
• The concurrent use of diuretics exacerbates PPI-induced hypomagnesemia.
• Hypomagnesemia can negatively affect renal function, particularly in CKD patients.

Conclusions:

• PPIs are a significant cause of hypomagnesemia, with increased risk when combined with diuretics.
• Hypomagnesemia poses a considerable threat to renal function in CKD patients.
• Understanding these mechanisms is vital for managing electrolyte balance in patients on PPIs and diuretics, especially those with CKD.