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Fatal Hypermagnesemia Due to Laxative Use.

The American journal of the medical sciences
April 1, 2018
Syed Rizwan Bokhari et al. (4 authors)
Case ReportsJournal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to investigate the fatal risks of hypermagnesemia due to magnesium-based laxatives in a patient with chronic constipation and normal renal function.

Results Summary

The study found that severe hypermagnesemia, caused by magnesium-based laxatives, led to fatal outcomes despite normal kidney function and renal replacement therapy. Retention of magnesium in the gut acted as a continuous absorption reservoir, contributing to mortality.

Population

A 53-year-old woman with chronic constipation and acute exacerbation of chronic obstructive pulmonary disease.

Effective Dosage

Not specified (regular use of magnesium-containing laxatives).

Duration

Not specified (acute hospitalization period).

Interactions

None mentioned.

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
magnesium-containing laxatives
increase
fatal hypermagnesemia
a 53-year-old woman with chronic constipation
-
resulted in
#1
magnesium-containing laxatives
increase
magnesium level
a 53-year-old woman
10.8mg/dL
rose to a peak of
#2
Continuous renal replacement therapy
decrease
serum magnesium levels
a 53-year-old woman
-
reduced
#3
severe hypermagnesemia
increase
death
individuals with normal renal function
-
frequently results in
#4
retention of magnesium-based laxative in the gut
increase
mortality
patients with constipation
-
serves as a reservoir for continuous magnesium absorption and contributes to
#5
Abstract

We report a case of fatal hypermagnesemia in a 53-year-old woman admitted for acute exacerbation of chronic obstructive pulmonary disease and with a history of chronic constipation treated regularly with magnesium-containing laxatives. On admission, her magnesium level was 2.0mg/dL, which rose to a peak of 10.8mg/dL despite hydration and diuresis in the presence of a normal kidney function. Continuous renal replacement therapy was promptly initiated, which reduced her serum magnesium levels, but her condition continued to deteriorate precipitously progressing to shock leading to oligoanuric renal failure, and she died 2 days later. A review of the literature shows that though rare and often unsuspected, severe hypermagnesemia frequently results in death even in individuals with normal renal function despite renal replacement therapy. In patients with constipation, retention of magnesium-based laxative in the gut apparently serves as a reservoir for continuous magnesium absorption and contributes to mortality.

Medical Subject Headings (MeSH)
Acute Kidney InjuryCitric AcidConstipationFatal OutcomeFemaleHumansLaxativesMagnesiumMagnesium OxideMiddle AgedOrganometallic CompoundsRenal Dialysis
Study Links
Quality Scores
Safety20
Quality60/10
Citation Metrics
Total Citations24
Citations/Year3.4
Relative Citation Ratio1.74
NIH Percentile70.2%
Research Impact Scores
APT Score0.75
Weight Score1.82
Normalized Score0.40
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