Prevalence of Hypomagnesemia in Hypokalemic Patients Admitted to Ghaem Hospital, Mashhad, in 2022

Document Type : Original article

Authors

1 Department of Internal Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Mashhad University of Medical Sciences, Mashhad, Iran

3 Assistant Professor of Health Information Technology Department, Varestegan Medical Sciences Higher Education Center, Mashhad, Iran

10.22038/nnj.2025.82740.1461

Abstract

Background and Aims: Potassium plays a key role in maintaining normal cell function. Hypokalemia, which is a serum potassium concentration of less than 3.5 milliequivalents per liter, has various causes, one of which is hypomagnesemia. This study was conducted to determine the prevalence of hypomagnesemia with simultaneous serum hypokalemia in patients hospitalized in Ghaem Hospital.
Materials and Methods: This study was designed as a cross-sectional-analytical study. Patients hospitalized in Ghaem Hospital in 1402 (A.D.) who had hypokalemia below 3 milliequivalents per liter and were over 16 years of age were included in the study as available. Then, they were asked for their serum magnesium levels, and if they had hypomagnesemia, they were included in the study. The data were analyzed using SPSS version 26 statistical software and descriptive statistics (mean, percentage, and frequency) and Spearman correlation.
Results: The number of subjects studied was 1768, who were selected through a convenient and purposeful method. Of these, 936 (52.9%) were women and the mean age of the patients was 59.54 years. The mean serum potassium and magnesium of the patients were 2.97 and 1.96, respectively. In examining the relationship between age and gender with the incidence of hypokalemia, no significant relationship was found (p-value > 0.05). In examining the relationship between hypokalemia and hypomagnesemia, it was shown that hypomagnesemia has a direct relationship with hypokalemia and their relationship is significant (p-value < 0.001).
Conclusion: The results of this study showed that paying attention to hypomagnesemia in patients with hypokalemia is very important because there is a direct relationship between the simultaneous occurrence of hypomagnesemia and hypokalemia, and hypomagnesemia can also increase the incidence of hypokalemia in patients with electrolyte disorders.

Keywords


[1]        Elliott TL, Braun M. Electrolytes: Potassium Disorders. FP essentials. 2017;459:21-8.
[2]        Weir MR, Rolfe M. Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors. Clinical Journal of the American Society of Nephrology. 2010;5(3):531-48.
[3]        McDonough AA, Youn JH. Potassium homeostasis: the knowns, the unknowns, and the health benefits. Physiology. 2017;32(2):100-11.
[4]        Houston MC, Harper KJ. Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension. The Journal of Clinical Hypertension. 2008;10(7):3-11.
[5]        Palmer BF, Clegg DJ. Physiology and pathophysiology of potassium homeostasis. Advances in physiology education. 2016;40(4):480-90.
[6]        Qian TDQ. Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update. 2017.
[7]        Udensi UK, Tchounwou PB. Potassium homeostasis, oxidative stress, and human disease. International journal of clinical and experimental physiology. 2017;4(3):111.
[8]        Gumz ML, Lynch IJ, Greenlee MM, Cain BD, Wingo CS. The renal H+-K+-ATPases: physiology, regulation, and structure. American Journal of Physiology-Renal Physiology. 2010;298(1):F12-F21.
[9]        Khitan ZJ, Shweihat YR, Tzamaloukas AH, Shapiro JI. Dietary potassium and cardiovascular profile. Results from the modification of diet in renal disease dataset. The Journal of Clinical Hypertension. 2018;20(3):611.
[10]      Palmer BF, Perazella MA, Choi MJ. American Society of Nephrology Quiz and Questionnaire 2013: electrolyte and acid-base. Clinical Journal of the American Society of Nephrology. 2014;9(6):1132-7.
[11]      Patel K, McCoy JV, Davis PM. Recognizing thyrotoxic hypokalemic periodic paralysis. JAAPA. 2018;31(1):31-4.
[12]      Clausen T. Hormonal and pharmacological modification of plasma potassium homeostasis. Fundamental & clinical pharmacology. 2010;24(5):595-605.
[13]      Tran TT, Pease A, Wood AJ, Zajac JD, Mårtensson J, Bellomo R, et al. Review of evidence for adult diabetic ketoacidosis management protocols. Frontiers in Endocrinology. 2017;8:106.
[14]      Zacchia M, Abategiovanni ML, Stratigis S, Capasso G. Potassium: from physiology to clinical implications. Kidney Diseases. 2016;2(2):72-9.
[15]      Cotruvo JA, Bartram J. Calcium and magnesium in drinking-water: Public health significance: World Health Organization; 2009.
[16]      Ahmed F, Mohammed A. Magnesium: the forgotten electrolyte—a review on hypomagnesemia. Medical Sciences. 2019;7(4):56.
[17]      Hayes J, Ryan M, Brazil N, Riordan T, Walsh J, Coakley D. Serum hypomagnesaemia in an elderly day-hospital population. Irish medical journal. 1989;82(3):117-9.
[18]      Wong ET, Rude RK, Singer FR, Shaw Jr S. A high prevalence of hypomagnesemia and hypermagnesemia in hospitalized patients. American journal of clinical pathology. 1983;79(3):348-52.
[19]      RUBEIZ GJ, THILL-BAHAROZIAN M, HARDIE D, CARLSON RW. Association of hypomagnesemia and mortality in acutely ill medical patients. Critical care medicine. 1993;21(2):203-9.
[20]      Soliman HM, Mercan D, Lobo SS, Mélot C, Vincent J-L. Development of ionized hypomagnesemia is associated with higher mortality rates. Critical care medicine. 2003;31(4):1082-7.
[21]      Tong GM, Rude RK. Magnesium deficiency in critical illness. Journal of intensive care medicine. 2005;20(1):3-17.
[22]      Whang R, Whang DD, Ryan MP. Refractory potassium repletion: a consequence of magnesium deficiency. Archives of internal medicine. 1992;152(1):40-5.
[23]      Huang C-L, Kuo E. Mechanism of hypokalemia in magnesium deficiency. Journal of the American Society of Nephrology. 2007;18(10):2649-52.
[24]     Peyvandi Yazdi, A., et al. "Evaluation of the prevalence of hypomagnesemia in the first 24th hour after selective operations in intensive care unit patients." Quarterly of the Horizon of Medical Sciences 20.1 (2014): 29-33.
 [25]   Khorashad K, Ahmad, Nia V, Hassan, Naqvi, Amirmajdi M, et al. Investigation of hypomagnesemia complication caused by proton pump inhibitors. Journal of the Faculty of Medicine, Mashhad University of Medical Sciences. 2015;58(3):126.
[26]    Dent A, Selvaratnam R. Measuring magnesium–Physiological, clinical and analytical perspectives. Clinical Biochemistry. 2022;105:1-15.
[27]      Parthasarathy S, Ravishankar M. Potassium ion and anaesthetic implications. Journal of Anaesthesiology Clinical Pharmacology. 2007;23(2):129-44.
[28]      Jahnen-Dechent W, Ketteler M. Magnesium basics. Clinical kidney journal. 2012;5(Suppl_1):i3-i14.
[29]      Roberts L. Partial correlation of some blood constituents. Clinical Chemistry. 1972;18(11):1407-10.
[30]      Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, et al. AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation. 2000;102(18):2284-99.
[31]      Matsui H, Shimosawa T, Uetake Y, Wang H, Ogura S, Kaneko T, et al. Protective effect of potassium against the hypertensive cardiac dysfunction: association with reactive oxygen species reduction. Hypertension. 2006;48(2):225-31.
[32]      Mayee KR, Maheshwaram V, Kamjula S, Srujana K, Vasa NK, Yerramilli A, et al. A Study on Evaluation of Potassium Abnormalities in a Tertiaty Care Hospital. Int J Pharm Pharm Sci. 2019;11(4):104-7.
[33]      Romel MSH, Afrin R. Frequency of Hypomagnesemia in Patients with Hypokalemia Admitted in A Tertiary Care Hospital. European Journal of Medical and Health Sciences. 2023; 5(4):19-23.