Disappearance of uraemic pruritus after lowering dialysate magnesium concentration.

Abstract

Thrombosis of leg arteries after prolonged travelVenous thrombosis and subsequent pulmonary embolism after prolonged sedentary travel have been reported.'-3 We describe three cases of thrombosis of leg arteries after prolonged travel. Case reportsCase 1-A 68-year-old man presented with pain in his right calf similar to cramp after a flight lasting at least 20 hours from Australia to England. After arriving home his calf became more painful and the foot cold and numb. There was gradual improvement over the next few days, but seven days after arrival in England he sought hospital treatment. He was fit, blood pressure 140/80 mm Hg, in sinus rhythm, with no ankle oedema or calf tenderness. All pulses in the left leg were present and normal. The right common femoral pulse was present, but all pulses below this in the right leg were absent. There was reduced sensation in the right foot, which was cool. He had a block of his right superficial femoral artery. He was given intravenous heparin and subsequently warfarin. A right femoral arteriogram taken six days after admission (see figure) showed a complete block of his right superficial femoral artery, and there were signs of thrombosis. Interestingly there were multiple collateral channels suggesting

Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions

“…In PD, dialysate Mg concentrations have changed from 0.75 to 0.25 mmol/L. These changes may be attributable to concerns regarding the suggestion by some studies of the adverse influence of hypermagnesemia on renal osteodystrophy [25], uremic pruritus [26], and visceral calcification [27] and the introduction of Mg-containing phosphate binders. Serum Mg levels in dialysis patients have been decreased by the changes of dialysate Mg concentrations, and hypomagnesemia rather than hypermagnesemia is now becoming an issue of interest due to its potent harmful influence.…”

Loss of the Philadelphia chromosome in chronic myeloid leukaemia associated with coeliac disease and splenic atrophy

“…One case of recalcitrant uraemic pruritus that responded dramatically to lowering the serum magnesium concentration has been described. 4 The correlation of magnesium concentrations with renal itch in this study provides further evidence of the potential role of this ion. The mechanism can currently only be conjectured.…”

“…It is, however, quite a serious step to advise someone to avoid important staple foods, especially if many foods are involved, or if the patient is a young child. 4 The experimental procedure described above is simple and inexpensive and requires only the cooperation of an impartial observer who will prepare the "blind" antigens. Practitioners who use tests without formal validation may wish to apply similar investigations to their own diagnostic procedures.…”

TRP Channels and Pruritus

“…In rats, insufficient dietary magnesium intake leads to low serum Mg 2+ concentration which results in the development of dermatitis and intense scratching [374]. Likewise, pruritus of uremic patients completely disappeared after normalizing the concentration of magnesium Mg 2+ in the dialysate [375]. Interestingly, EGF, a central growth factor in epidermal differentiation, has a crucial role in controlling the proper function of TRPM6 [376], besides that of TRPV3 (see above).…”