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January 1992

Refractory Potassium Repletion: A Consequence of Magnesium Deficiency

Author Affiliations

From the Department of Medicine, University of Oklahoma and Veterans Administration Medical Center, Oklahoma City (Dr R. Whang); Department of Medicine, Indiana University, Indianapolis (Dr D. Whang); and Department of Pharmacology, University College, Dublin, Ireland (Dr Ryan).

Arch Intern Med. 1992;152(1):40-45. doi:10.1001/archinte.1992.00400130066006

Experimental and clinical observations support the view that uncorrected magnesium (Mg) deficiency impairs repletion of cellular potassium (K). This is consistent with the observed close association between K and Mg depletion. Concomitant Mg deficiency in K-depleted patients ranges from 38% to 42%. Refractory K repletion due to unrecognized concurrent Mg deficiency can be clinically perplexing. Refractory K repletion as a consequence of Mg deficiency may be operative in patients with congestive failure, digitalis toxicity, cisplatin therapy, and in patients receiving potent loop diuretics. Therefore, we recommend that: (1) serum Mg be routinely assessed in any patients in whom serum electrolytes are necessary for clinical management and (2) until serum Mg is routinely performed consideration should be given to treating hypokalemic patients with both Mg as well as K to avoid the problem of refractory K repletion due to coexisting Mg deficiency.

(Arch Intern Med. 1992;152:40-45)

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