[Magnesium disorders].

Extracellular content in magnesium represents about 1% of total body content, of which plasma magnesium is thus a poor reflect. Hypomagnesaemia is defined by a value lesser than 0.65mmol/L. Its incidence in hospitalized patients ranges between 10 and 15%. Identification of the physiopathology of hypomagnesaemia relies first upon concomitant measurement of plasma and urinary magnesium concentration. Daily magnesium excretion lesser than 1mmol/L or EFMg lesser than 1% sign extra renal origin, due to either low magnesium intake, low intestinal absorption of magnesium or derivation of extracellular magnesium toward bone, such as in bone reparation process after hyperparathyroidism surgery. Daily magnesium excretion higher than 2mmol/L concomitant to hypomagnesaemia indicates native or acquired renal loss of magnesium. Congenital renal and extra-renal losses of magnesium are mainly related to rare monogenic disease, and are inconstantly associated with a renal loss of sodium, potassium and calcium. Recent progress in the genetics of this rare diseases have greatly improved the knowledge about proteins involved in intestinal abortion, renal renal tubular re-absorption of magnesium and its regulations. Hypermagnesemia is a rarer metabolic disorder than hypomagnesemia (about 5% of hospitalized patients). Asymptomatic below 2mmol/L, it progressively alters neuromuscular transmission, autonomic sympathic activity and cardiac conduction, with vital risk above 7mol/L. It is due to acute magnesium input into extracellular volume most often associated with a decrease in glomerular filtration rate, limiting the high physiological ability to excrete magnesium input.
(Copyright © 2012 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.)