Hypermagnesemia

Acute or chronic kidney disease

• Decreased GFR → ↓ filtration and ↓ phosphorus excretion

Excessive magnesium intake

• Laxative, bowel prep

• IV fluids

• Supplementation

• Usually asymptomatic unless extremely high

• Loss of deep tendon reflexes (DTRs)

• Weakness

• Cardiac dysrhythmias

• Coma

• Evaluate history for sources of excessive magnesium intake

• Labs:

  • Kidney function

• Reduce intake of magnesium

• Volume expansion and/or loop diuretics if no improvement despite reduction of intake

• Administer calcium if severe and/or symptomatic