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      Maintenance Hemodialysis and Circulating Ionized Magnesium

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          Abstract

          Background: Circulating magnesium exists in the bound and in the free ionized form, that is biologically active. In kidney disease the relationship between ionized and total circulating magnesium is often altered. Little information is available on the influence of hemodialysis on the relationship between ionized and total circulating magnesium in end-stage kidney disease. Methods: Plasma total and ionized magnesium and the plasma ionized magnesium fraction were assessed before and after hemodialysis (dialysate magnesium content 0.75 mmol/l) in 46 patients with end-stage kidney disease and in a control group of 25 healthy subjects. Results: In patients plasma total (from 1.19 [1.05–1.33] to 1.10 [1.02–1.16] mmol/l; median and interquartile range) and ionized (from 0.71 [0.66–0.78] to 0.65 [0.63–0.69] mmol/l) magnesium significantly decreased during dialysis (control subjects: 0.82 [0.80–0.92], respectively, 0.57 [0.54–0.59] mmol/l). The plasma ionized magnesium fraction was significantly lower in patients both before (0.61 [0.58–0.64)] and after (0.60 [0.56–0.62]) hemodialysis than in controls (0.68 [0.65–0.70]). Conclusion: The study demonstrates a tendency towards a reduced circulating ionized magnesium fraction in end-stage kidney disease that is not corrected by hemodialysis.

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          Circulating Ionized and Total Magnesium in End-Stage Kidney Disease

          Background: Circulating magnesium exists in the ionized state and in the undissociated form, either bound to albumin, or complexed to various anions. Until recently, only the measurement of total plasma magnesium has been possible. Now circulating ionized magnesium can be assessed as well. Methods: Total and ionized plasma magnesium were determined in 43 patients on maintenance hemodialysis (dialysate composition: calcium 1.75 mmol/l, magnesium 0.75 mmol/l) before a dialysis session and in a group of 23 healthy subjects. Results: The total (1.16 [1.03–1.31] versus 0.81 [0.78–0.89] mmol/l; median and interquartile range) and the ionized (0.71 [0.66–0.78] versus 0.54 [0.53–0.59] mmol/l) plasma magnesium levels were significantly higher (p < 0.01) and the ionized plasma magnesium fraction lower (0.61 [0.58–0.65] versus 0.67 [0.64–0.70]; p < 0.02) in patients than in controls. Conclusion: The determination of circulating ionized magnesium using selective electrodes is an attractive method to evaluate extracellular magnesium in kidney disease.
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            Plasma ionized magnesium in tubular disorders with and without total hypomagnesemia

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              Childhood Insulin-Dependent Diabetes mellitus: Initial Presentation and Management in the Nineties

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                Author and article information

                Journal
                NEF
                Nephron
                10.1159/issn.1660-8151
                Nephron
                S. Karger AG
                1660-8151
                2235-3186
                2002
                September 2002
                26 September 2002
                : 92
                : 3
                : 616-621
                Affiliations
                Inselspital, University of Berne, Switzerland
                Article
                64109 Nephron 2002;92:616–621
                10.1159/000064109
                12372946
                © 2002 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 2, References: 16, Pages: 6
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/64109
                Categories
                Original Paper

                Cardiovascular Medicine, Nephrology

                Uremia, Hemodialysis, Magnesium, Acid-base equilibrium

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