Amiloride for the treatment of cisplatin-induced hypomagnesemia

Hypomagnesemia secondary to cisplatin-induced nephrotoxicity is caused by a tubular defect that results in renal loss of magnesium. The objective was to evaluate the effect of amiloride in patients with cisplatin-induced hypomagnesemia. To this end, we included nine cancer patients who were evaluated sequentially in three stages: without corrective treatment, with magnesium supplementation, and with combined treatment of magnesium plus amiloride. Magnesium supplementation increased serum magnesium levels compared with no treatment (1.22 ± 0.07 vs. 1.01 ± 0.13 mg/dl; p < 0.01), without reducing urinary magnesium excretion. The addition of amiloride produced a further increase in serum magnesium levels (1.38 ± 0.17 mg/dl; p <0.05) and was associated with a significant decrease in magnesium excretion and fractional magnesium excretion (p <0.01). No episodes of hyperkalemia were observed. Amiloride reduced hypermagnesuria and increased serum magnesium levels in patients with cisplatin-induced nephrotoxicity.