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Published ahead of print on September 5, 2007
J Am Soc Nephrol 18: 2649-2652, 2007
© 2007 American Society of Nephrology
doi: 10.1681/ASN.2007070792
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Science in Renal Medicine

Mechanism of Hypokalemia in Magnesium Deficiency

Chou-Long Huang*,{dagger} and Elizabeth Kuo*

* Department of Medicine, {dagger} Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas

Correspondence to: Dr. Chou-Long Huang, or Dr. Elizabeth Kuo, UT Southwestern Medical Center, Department of Medicine, 5323 Harry Hines Boulevard, Dallas, TX 75390-8856. Phone: 214-648-8627; Fax: 214-648-2071; E-mail: chou-long.huang{at}utsouthwestern.edu; elizabeth.kuo{at}utsouthwestern.edu

Magnesium deficiency is frequently associated with hypokalemia. Concomitant magnesium deficiency aggravates hypokalemia and renders it refractory to treatment by potassium. Herein is reviewed literature suggesting that magnesium deficiency exacerbates potassium wasting by increasing distal potassium secretion. A decrease in intracellular magnesium, caused by magnesium deficiency, releases the magnesium-mediated inhibition of ROMK channels and increases potassium secretion. Magnesium deficiency alone, however, does not necessarily cause hypokalemia. An increase in distal sodium delivery or elevated aldosterone levels may be required for exacerbating potassium wasting in magnesium deficiency.




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