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September 22, 1978

Hypermagnesemia Following Irrigation of Renal Pelvis: Cause of Respiratory Depression

Author Affiliations

From the Departments of Medicine (Drs Jenny, Goris, and Brian) and Urological Surgery (Dr Urwiller), St Joseph Hospital, Denver.

JAMA. 1978;240(13):1378-1379. doi:10.1001/jama.1978.03290130072028

HYPERMAGNESEMIA is most commonly associated with renal insufficiency or an exogenous source of magnesium.1 Although magnesium-containing antacids and cathartics constitute the most common source of exogenous magnesium,2 urologic irrigation solutions, used for the dissolution of urinary calculi, may also contain magnesium.3 While modest elevations in serum magnesium have been described with the use of such irrigation solutions,4 elevations of this ion sufficient to cause respiratory paralysis have, to our knowledge, not been previously reported. We treated such a patient.

Report of a Case  A 35-year-old man, paraplegic as a result of a thoracolumbar menigomyelocele, was admitted to St Joseph Hospital on Aug 3, 1977, for evaluation of fever and foul-smelling urine of 24 hours' duration. The patient had a chronic suprapubic catheter and in the past had had numerous episodes of urinary tract infections associated with right renal calculi and mild chronic renal insufficiency. There was no