Concerning the Effects of Magnesium Sulfate on Renal Function, Electrolyte Excretion, and Clearance of Magnesium 1

Heller, B.I.; Hammarsten, James F.; Stutzman, Francis L.

doi:10.1172/jci102803

Cited by 50 publications

(19 citation statements)

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“…Although several investigators (1)(2)(3)(4)(5)(6)(7)(8) have shown that the renal clearance (or excretion) of magnesium increases after the injection of magnesium salts, no data have been published to show how the renal clearance of magnesium depends upon the serum magnesium concentration.…”

Section: Discussionmentioning

confidence: 99%

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Some Effects of Magnesium Loading upon Renal Excretion of Magnesium and Certain Other Electrolytes1

Chesley¹,

Tepper²

1958

J. Clin. Invest.

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Mendel and Benedict (1) injected magnesium salts into animals and found that nearly all of the magnesium could be recovered in the urine. Incidentally, they noted that magnesium injections were followed by "a noteworthy rise in the urinary output of calcium." Schwartz, Smith and Winkler (2) made some measurements of the magnesium clearance in their study of the renal excretion of sulfate by dogs. They found that the renal clearance of magnesium was always less than that of sulfate and, therefore, "presumably the excretion of a small amount of some other cation was stimulated, in order to ensure continuous electroneutrality of urine." Chloride excretion was "almost completely repressed by sulfate excretion." In control periods, in three dogs, the renal clearances of magnesium were 2, 1 and 2 ml. per minute. Following the injection of magnesium sulfate, in five dogs, the magnesium clearances ranged from 12 to 24 ml. per minute with magnesium to creatinine clearance ratios ranging from 0.293 to 0.45.Several investigators (3-6) have since found that the magnesium clearance increases after the injection of magnesium salts, although what appears to be the only study systematically relating clearances to plasma concentrations of magnesium has been published only in abstract form (7,8).Magnesium clearances, which usually have been calculated as UmgV/Pmg, are not a simple reflection of how the kidney handles this element. Copeland and Sunderman (9), as well as others whose work they review, have shown that a third or more of the plasma magnesium is bound to proteins and therefore not filtrable at the glomerulus. Willis and Sunderman (10) have published nomograms from which filtrable magnesium and magnesium concentrations in ultrafiltrates of se-' Supported by Research Grant H-1837 from the National Institutes of Health, Public Health Service. rum may be derived from the total magnesium and protein concentrations in serum.The present paper extends the observations reported by others by studying the effects of magnesium over a wider range of serum concentrations, over rising, constant and falling serum levels, and in subjects whose glomerular filtration rates ranged from 25 to 196 ml. per minute. MATERIAL AND METHODSThirty-four women served as subjects of the study. None of the five nonpregnant women had any discernible disturbance in hydration or cardiovascular-renal function. The remaining 29 women were selected with a view to getting cases with a wide range of inulin clearances, with representatives throughout the range. These women were all pregnant and were distributed as follows: "normal", 4; preeclampsia, .14; hypertensive disease, 7; renal disease, thought to be chronic glomerulonephritis, 4. The patients with renal disease all had hypertension, proteinuria and renal impairment. The one who did not have edema, and who had not been seen here in a previous pregnancy, was in uremia and had a urea clearance of 3 ml. per minute. Another had a urea clearance of 30 ml. per minute and the remaining two had inulin clearance...

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Section: Discussionmentioning

confidence: 99%

“…Several investigators (3)(4)(5)(6) have since found that the magnesium clearance increases after the injection of magnesium salts, although what appears to be the only study systematically relating clearances to plasma concentrations of magnesium has been published only in abstract form (7,8).…”

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confidence: 99%

Some Effects of Magnesium Loading upon Renal Excretion of Magnesium and Certain Other Electrolytes1

Chesley¹,

Tepper²

1958

J. Clin. Invest.

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“…Potassium excretion in man usually decreases following parenteral injection of magnesium salts (32,33) (Table II). The hypothesis has been suggested that magnesium, a divalent ion, may enter into a univalent ion exchange mechanism, resulting in a decreased excretion of potassium (32).…”

Section: Effect Of Acid-base Changesmentioning

confidence: 99%

“…The hypothesis has been suggested that magnesium, a divalent ion, may enter into a univalent ion exchange mechanism, resulting in a decreased excretion of potassium (32). The failure of potassium chloride ingestion to produce a consistent effect on magnesium excretion does not lend support to such a suggestion (34).…”

Section: Effect Of Acid-base Changesmentioning

confidence: 99%

Studies of the Renal Excretion of Magnesium in Man*†

Barker¹,

Elkinton²,

Clark³

1959

J. Clin. Invest.

104

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Magnesium is one of the four principal cations in extracellular fluid, and in intracellular fluid is exceeded only by potassium; yet comparatively little is known about the mechanisms involved in the renal excretion of magnesium. That such is the case must be due to a variety of factors which include difficulties in chemical analysis, the binding by protein of a relatively large portion of the ion in serum, and the formation of soluble complexes which may be handled by the kidney in a different manner from that of the ion. Such difficulties probably account for the relatively few studies to date of magnesium excretion.The experiments reported here involve 70 acute studies in man performed by usual clearance techniques. Renal hemodynamics and excretion rates of magnesium and other electrolytes were observed during multiple control periods and following eight principal experimental procedures. These were intravenous infusions of sodium lactate, sodium bicarbonate, acetazolamide, probenecid, sodium para-aminohippurate (PAH) to tubular saturation, magnesium salts, calcium salts and mercurial diuretics.The data provide a basis for examination of factors likely to affect magnesium excretion and in some instances of probable renal mechanisms involved. The major part of filtered magnesium is reabsorbed by the tubules. The existence of a quantitatively small, but perhaps important, regulatory tubular secretion of magnesium is suggested by certain indirect evidence, but is not settled by present data. In addition to changes in filtered magnesium, consideration is given to possible ef-*Laboratory facilities were aided by grants from the National Heart Institute of the United States Public Health Service fects on tubular magnesium transport of such factors as acid-base balance, possible relation to known active transport systems, specific interionic relationships especially with calcium or potassium, and formation of soluble magnesium complexes. METHODSGeneral. Fifty-three normal men between the ages of 18 and 32 served as experimental subjects for one or more renal clearance studies by standard techniques (4) with bladder catheterization and standard water loading. Control results reported are averages from three or more periods of at least 15 minutes each which followed an equilibration period of at least 45 minutes.Test procedures. The test procedure in each case consisted of the intravenous administration of some electrolyte solution or pharmacological agent. The eight major types of experiments are described below. Additional procedures were carried out to elucidate specific points and will be mentioned in appropriate sections. 1) Sodium lactate, 2.4 mEq. per Kg. body weight, as a hypertonic (0.9 M) solution was given rapidly (10 minutes) in six studies. Whenever results of lactate administration are referred to without qualification in this report it should be understood that these are the studies meant. In four other studies alterations were made in the dosage or time of administration of lactate for comparison wit...

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“…Moreover, magnesium infusion decreases urinary K ϩ excretion in normal individuals. 7 K ϩ is freely filtered at the glomerulus. Most of the filtered K ϩ is reabsorbed by the proximal tubule and the loop of Henle.…”

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confidence: 99%