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Refractory Potassium Repletion: A Consequence of Magnesium Deficiency

Refractory Potassium Repletion: A Consequence of Magnesium Deficiency Abstract 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) References 1. Whang R, Whang DD. Update: mechanisms by which magnesium modulates intracellular potassium . J Am Coll Nutr. 1990;9:84-85Crossref 2. Whang R. Magnesium deficiency, pathogenesis, prevalence and clinical implications . Am J Med. 1987;82( (suppl 3A) ): 24-29.Crossref 3. Iseri LT, Allen BJ, Brodsky MA. Magnesium therapy of cardiac arrhythmias in critical-care medicine . Magnesium. 1989;8:299-306. 4. Tzivoni D, Keren A. Suppression of ventricular arrhythmias by magnesium . Am J Cardiol. 1990;65:1397-1399.Crossref 5. Whang R, Oei TO, Watanabe A. Frequency of hypomagnesemia in hospitalized patients receiving digitalis . Arch Intern Med. 1985;145:655-656.Crossref 6. Brady H, Ryan MP, Horgan J. Magnesium: the forgotten cation . Ir Med J. 1987;80:250-253. 7. Ryan MP, Brady H. The role of magnesium in the prevention and control of hypertension . Ann Clin Res. 1984;16( (suppl 43) ):81-88. 8. Whang R, Oei TO, Aikawa JK, et al. Predictors of clinical hypomagnesemia . Arch Intern Med. 1984;144:1794-1796.Crossref 9. Elin RJ. Magnesium metabolism in health and disease . Dis Mon. 1988;166-218. 10. Reinhart RA. Magnesium metabolism . Arch Intern Med. 1988;148:2415-2420.Crossref 11. National Research Council. Recommended Dietary Allowances . 10th ed. Orlando, Fla: Academic Press Inc; 1989:190-191. 12. Seelig M. Cardiovascular consequence of magnesium deficiency and loss: pathogenesis prevalence and manifestations—magnesium and chloride loss in refractory potassium repletion . Am J Med. 1989;63:46-216. 13. Ryan MP. The renal handling of magnesium . In: Siegel H, Seelig A, eds. Metal Ions in Biological Systems: Compendium on Magnesium and its Role in Biology, Nutrition and Physiology . New York, NY: Marcel Dekker Inc; 1990;14:249-269. 14. Quamme GA, Dirks JH. The physiology of renal magnesium handling . Renal Physiol. 1986;9:257-269. 15. Alfrey AC, Terman DS, Brettschneider L, Simpson KM, Ogden DA. Hypermagnesemia after renal homotransplantation . Ann Intern Med. 1970;73:367-371.Crossref 16. Mordes JP, Swartz R, Arky RA. Extreme hypermagnesemia as a cause of refractory hypotension . Ann Intern Med. 1975;83:657-658.Crossref 17. Ferdinandus J, Pederson JA, Whang R. Hypermagnesemia as a cause of refractory hypotension, respiratory depression and coma . Arch Intern Med. 1981;141:669-670.Crossref 18. Wester PO, Dyckner T. Diuretic treatment and magnesium losses . Acta Med Scand. 1981;647( (suppl) ):145-152. 19. Ryan MP, Devane J, Ryan MF, Counihan TB. Effects of diuretics on the renal handling of magnesium . Drugs. 1984;28( (suppl 1) ):167-181.Crossref 20. Dyckner T, Hallbert D, Hultman E, Wester PO. Magnesium deficiency following jejuno-ileal bypass operations for obesity . J Am Coll Nutr. 1982;1:239-246.Crossref 21. Whang R, Aikawa JK, Oei TO, Hamiter T. Routine serum magnesium determination—an unrecognized need . In: Cantin M, Seelig MS, eds. Magnesium in Health and Diseases . New York, NY: SP Medical & Scientific Books; 1980:1-5. 22. Wong ET, Rude RK, Singer FR, Shaw ST Jr. A high prevalence of hypomagnesemia in hospitalized patients . Am J Clin Pathol. 1983;79:348-352. 23. Reinhart RA, Desbiens NA. Hypomagnesemia in patients entering the ICU . Crit Care Med. 1985;13:506-507.Crossref 24. Whang R, Ryder KW. Frequency of hypomagnesemia and hypermagnesemia . JAMA. 1990;263:3063-3064.Crossref 25. Whang R. Routine serum magnesium determination: a continuing unrecognized need . Magnesium. 1987;6:1-4. 26. Flink EB. Magnesium deficiency: etiology and clinical spectrum . Acta Med Scand. 1981;647( (suppl) ):125-137. 27. Whang R, Ryder KW. Hypomagnesemia . In: Taylor RB, ed. Difficult Diagnosis II . Philadelphia, Pa: WB Saunders Co. In press. 28. Flink EB. Magnesium deficiency in alcoholism . Alcoholism. 1986;10:590-594.Crossref 29. Kalbfleisch L, Lindemann RD, Ginn HE, Smith WO. Effects of ethanol administration on urinary excretion of magnesium and other electrolytes in alcoholic and normal subjects . J Clin Invest. 1963;42:1471-1475.Crossref 30. Gustafson T, Boman K, Hentschel J, Moberg E, Ringqvist I, Wester PO. Effects of peroral magnesium on electrolytes and ventricular premature beats in patients with cardiac failure on diuretic treatment . Magnesium Bull. 1990;12:106-111. 31. Ryan MP. Diuretics and magnesium/potassium depletion: directions for treatment . Am J Med. 1987;82( (suppl 3A) ):38-47.Crossref 32. Whang R, Chrysant S, Dillard B, Smith W. Hypomagnesemia and hypokalemia in 1000-treated ambulatory hypertensive patients . J Am Coll Nutr. 1982;1:317-322.Crossref 33. Dyckner T, Wester PO. Effects of magnesium on blood pressure . BMJ. 1983;286:1847-1849.Crossref 34. Wester PO, Dyckner T. Magnesium and hypertension . J Am Coll Nutr. 1987;6:321-328.Crossref 35. Dyckner T, Wester PO. Potassium/magnesium depletion in patients with cardiovascular disease . Am J Med. 1987;262( (suppl 3A) ):11-17.Crossref 36. Ryan MP, Ryan MF, Counihan TB. The effect of diuretics on lymphocyte magnesium and potassium . Acta Med Scand. 1981;647( (suppl) ):153-161. 37. Njinimbam CCG, Ryder KW, Glick MR, Glick SR, Whang R. Identification and treatment of hypomagnesemia and hypokalemia in patients receiving digoxin . Clin Chem. 1990;36:575. 38. Ryan MF, Ryan MP. The effects of magnesium on the binding of H-digoxin to the membranes of intact human red blood cells . Ir J Med Sci. 1983;152:219. 39. Iseri LT, Freed J, Bures AR. Magnesium deficiency and cardiac disorders . Am J Med. 1975;58:837-846.Crossref 40. Firth BG, Yancy CW Jr. Survival in congestive heart failure: have we made a difference? Am J Med. 1990;80:1-3N. 41. Iseri LT, Fairshter RD, Hardemann JL, Brodsky MA. Magnesium and potassium therapy in multifocal atrial tachycardia . Am Heart J. 1985;110:789-794.Crossref 42. Abraham AS, Eylath U, Weinstein M, Czaczkes E. Serum magnesium levels in patients with acute myocardial infarction . N Engl J Med. 1977;296:862-863.Crossref 43. Dyckner T. Serum magnesium in acute myocardial infarction . Acta Med Scand. 1980;207:59-66.Crossref 44. Rasmussen HS. Clinical intervention studies on magnesium in myocardial infarction . Magnesium. 1989;8:316-325. 45. Flink EB, Brick JE, Shane SR. Alterations of long chain free fatty acid and magnesium concentrations in acute myocardial infarction . Arch Intern Med. 1981;141:441-443.Crossref 46. Abraham AS, Rosemann D, Kramer M, et al. Magnesium in the prevention of lethal arrhythmias in acute myocardial infarction . Arch Intern Med. 1987;147:753-755.Crossref 47. Casey B, Counihan TB, Ryan MP. The effects of anoxia and amelioration on 28Mg efflux in cultured cardiac cell line . Ir J Med Sci. 1988;157:360-361. 48. Dyckner T, Wester PO. Effects of magnesium infusion in diuretic induced hyponatremia . Lancet. 1981;1:585-586.Crossref 49. Dorup I, Skajaa K, Clausen T, Kjeldsen K. Reduced concentrations of potassium, magnesium and sodium-potassium pumps in human skeletal muscle during treatment with diuretics . BMJ. 1988;296:455-458.Crossref 50. Dorup I, Skajaa K, Thybo NC. Is it possible to restore the reduced concentrations of Mg, K and Na, K-pumps in muscle seen during long term diuretic treatment by an oral supplement of Mg? Presented at the Third European Congress on Magnesium; March 15, 1990; Geneva, Switzerland. 51. Whang R, Welt LG. Observations in experimental magnesium depletion . J Clin Invest. 1963;42:305-313.Crossref 52. Estep HL, Shaw WA, Watlington C, Hofe R, Holland W, Tucker S. Hypocalcemia due to hypomagnesemia and reversible parathyroid unresponsiveness . J Clin Endocrinol. 1969;29:842-848.Crossref 53. Massry SG. Pharmacology of magnesium . Ann Rev Pharmacol Toxicol. 1977;17:67-82.Crossref 54. Boyd JC, Bruns DE, Wills MR. Frequency of hypomagnesemia in hypokalemic states . Clin Chem. 1983;29:178-179. 55. Whang R, Aikawa JK. Magnesium deficiency and refractoriness to potassium repletion . J Chronic Dis. 1977;30:65-68.Crossref 56. Whang R, Flink EB, Dyckner T, Wester PO, Aikawa JK, Ryan MP. Magnesium depletion as a cause of refractory potassium repletion . Arch Intern Med. 1985;145:1686-1689.Crossref 57. Whang R, Ryder KW. lonicdisturbances in hospital practice: the case for magnesium . Magnesium Bull. 1990;12:122-126. 58. Skou JC. The influence of some cations in an adenosine triphosphatase from peripheral nerves . Biochem Biophys Acta. 1957;23:394-401.Crossref 59. Schilling K, Bornig H, Cumme G, Hoppe H. Effect of magnesium-dependent cell membrane alterations on the transport of K+ in Ehrlich ascites tumor cells . Acta Biol Med Ger. 1980;39:177-184. 60. Borchgrevink PC, Ryan MP. The effects of magnesium, ouabain and bumetanide on rubidium uptake in human atrial cell line . Br J Pharmacol. 1988;95:614-618.Crossref 61. Ryan MP. The role of magnesium in potassium deficiency . In: Whelton P, Whelton A, Walker WG, eds. Potassium in Cardiovascular and Renal Medicine, Arrhythmias, Myocardial Infarction and Hypertension . New York, NY: Marcel Dekker Inc; 1986;2:23-42. 62. Flatman PW. Regulation of potassium transport by magnesium . In: Reuss L, Russell JM, Szabo G, eds. Regulation of Potassium Transport Across Biological Membranes . Austin, Tex: University of Texas Press; 1990;9:191-212. 63. Matsuda H. Open-state substructure of inwardly rectifying potassium channels revealed by magnesium block in guinea-pig heart cells . J Physiol. 1988;397:237-258. 64. Vandenberg CA. Internal rectification of a potassium channel in cardiac ventricular cells depends on internal magnesium ions . Proc Natl Acad Sci U S A. 1987;84:2560-2564.Crossref 65. Ryan MP, Whang R, Yamalis W. Effect of magnesium deficiency on cardiac and skeletal muscle potassium during dietary potassium restriction . Proc Soc Exp Biol Med. 1973;143:1045-1047.Crossref 66. Whang R, Morosi HJ, Rodgers D, Reyes R. The influence of sustained magnesium deficiency on muscle potassium repletion . J Lab Clin Med. 1967;70:895-902. 67. Ryan MP, Hingerty D. Effects of magnesium deficiency on restoration of potassium and sodium levels in potassium-depleted muscle . Ir J Med Sci. 1969;2:137-140.Crossref 68. Rodriques M, Solanki DL, Whang R. Refractory potassium repletion due to cisplatin-induced magnesium depletion . Arch Intern Med. 1989;149:2592-2594.Crossref 69. Shils ME. Experimental human magnesium depletion . Medicine. 1969;48:61-85.Crossref 70. Baehler RW, Work J, Kotchen TA. Studies in the pathogenesis of Bartter's syndrome . Am J Med. 1980;69:933-938.Crossref 71. Gullner JG, Gill JR, Bartter FC. Correction of hypokalemia by magnesium repletion in familial hypokalemic alkalosis with tubulopathy . Am J Med. 1981;71:578-589.Crossref 72. Webb S, Schade DS. Hypomagnesemia as a cause of persistent hypokalemia . JAMA. 1975;233:23-24.Crossref 73. Whang R, Whang DD, Ryder KW, Oei TO. Routine serum magnesium determination: a contemporary clinical imperative . Magnesium Res. 1990;3:267-270. 74. Flink EB. Therapy of magnesium deficiency . Ann N Y Acad Sci. 1969;162:901-905.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Refractory Potassium Repletion: A Consequence of Magnesium Deficiency

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References (87)

Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1992.00400130066006
Publisher site
See Article on Publisher Site

Abstract

Abstract 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) References 1. Whang R, Whang DD. Update: mechanisms by which magnesium modulates intracellular potassium . J Am Coll Nutr. 1990;9:84-85Crossref 2. Whang R. Magnesium deficiency, pathogenesis, prevalence and clinical implications . Am J Med. 1987;82( (suppl 3A) ): 24-29.Crossref 3. Iseri LT, Allen BJ, Brodsky MA. Magnesium therapy of cardiac arrhythmias in critical-care medicine . Magnesium. 1989;8:299-306. 4. Tzivoni D, Keren A. Suppression of ventricular arrhythmias by magnesium . Am J Cardiol. 1990;65:1397-1399.Crossref 5. Whang R, Oei TO, Watanabe A. Frequency of hypomagnesemia in hospitalized patients receiving digitalis . Arch Intern Med. 1985;145:655-656.Crossref 6. Brady H, Ryan MP, Horgan J. Magnesium: the forgotten cation . Ir Med J. 1987;80:250-253. 7. Ryan MP, Brady H. The role of magnesium in the prevention and control of hypertension . Ann Clin Res. 1984;16( (suppl 43) ):81-88. 8. Whang R, Oei TO, Aikawa JK, et al. Predictors of clinical hypomagnesemia . Arch Intern Med. 1984;144:1794-1796.Crossref 9. Elin RJ. Magnesium metabolism in health and disease . Dis Mon. 1988;166-218. 10. Reinhart RA. Magnesium metabolism . Arch Intern Med. 1988;148:2415-2420.Crossref 11. National Research Council. Recommended Dietary Allowances . 10th ed. Orlando, Fla: Academic Press Inc; 1989:190-191. 12. Seelig M. Cardiovascular consequence of magnesium deficiency and loss: pathogenesis prevalence and manifestations—magnesium and chloride loss in refractory potassium repletion . Am J Med. 1989;63:46-216. 13. Ryan MP. The renal handling of magnesium . In: Siegel H, Seelig A, eds. Metal Ions in Biological Systems: Compendium on Magnesium and its Role in Biology, Nutrition and Physiology . New York, NY: Marcel Dekker Inc; 1990;14:249-269. 14. Quamme GA, Dirks JH. The physiology of renal magnesium handling . Renal Physiol. 1986;9:257-269. 15. Alfrey AC, Terman DS, Brettschneider L, Simpson KM, Ogden DA. Hypermagnesemia after renal homotransplantation . Ann Intern Med. 1970;73:367-371.Crossref 16. Mordes JP, Swartz R, Arky RA. Extreme hypermagnesemia as a cause of refractory hypotension . Ann Intern Med. 1975;83:657-658.Crossref 17. Ferdinandus J, Pederson JA, Whang R. Hypermagnesemia as a cause of refractory hypotension, respiratory depression and coma . Arch Intern Med. 1981;141:669-670.Crossref 18. Wester PO, Dyckner T. Diuretic treatment and magnesium losses . Acta Med Scand. 1981;647( (suppl) ):145-152. 19. Ryan MP, Devane J, Ryan MF, Counihan TB. Effects of diuretics on the renal handling of magnesium . Drugs. 1984;28( (suppl 1) ):167-181.Crossref 20. Dyckner T, Hallbert D, Hultman E, Wester PO. Magnesium deficiency following jejuno-ileal bypass operations for obesity . J Am Coll Nutr. 1982;1:239-246.Crossref 21. Whang R, Aikawa JK, Oei TO, Hamiter T. Routine serum magnesium determination—an unrecognized need . In: Cantin M, Seelig MS, eds. Magnesium in Health and Diseases . New York, NY: SP Medical & Scientific Books; 1980:1-5. 22. Wong ET, Rude RK, Singer FR, Shaw ST Jr. A high prevalence of hypomagnesemia in hospitalized patients . Am J Clin Pathol. 1983;79:348-352. 23. Reinhart RA, Desbiens NA. Hypomagnesemia in patients entering the ICU . Crit Care Med. 1985;13:506-507.Crossref 24. Whang R, Ryder KW. Frequency of hypomagnesemia and hypermagnesemia . JAMA. 1990;263:3063-3064.Crossref 25. Whang R. Routine serum magnesium determination: a continuing unrecognized need . Magnesium. 1987;6:1-4. 26. Flink EB. Magnesium deficiency: etiology and clinical spectrum . Acta Med Scand. 1981;647( (suppl) ):125-137. 27. Whang R, Ryder KW. Hypomagnesemia . In: Taylor RB, ed. Difficult Diagnosis II . Philadelphia, Pa: WB Saunders Co. In press. 28. Flink EB. Magnesium deficiency in alcoholism . Alcoholism. 1986;10:590-594.Crossref 29. Kalbfleisch L, Lindemann RD, Ginn HE, Smith WO. Effects of ethanol administration on urinary excretion of magnesium and other electrolytes in alcoholic and normal subjects . J Clin Invest. 1963;42:1471-1475.Crossref 30. Gustafson T, Boman K, Hentschel J, Moberg E, Ringqvist I, Wester PO. Effects of peroral magnesium on electrolytes and ventricular premature beats in patients with cardiac failure on diuretic treatment . Magnesium Bull. 1990;12:106-111. 31. Ryan MP. Diuretics and magnesium/potassium depletion: directions for treatment . Am J Med. 1987;82( (suppl 3A) ):38-47.Crossref 32. Whang R, Chrysant S, Dillard B, Smith W. Hypomagnesemia and hypokalemia in 1000-treated ambulatory hypertensive patients . J Am Coll Nutr. 1982;1:317-322.Crossref 33. Dyckner T, Wester PO. Effects of magnesium on blood pressure . BMJ. 1983;286:1847-1849.Crossref 34. Wester PO, Dyckner T. Magnesium and hypertension . J Am Coll Nutr. 1987;6:321-328.Crossref 35. Dyckner T, Wester PO. Potassium/magnesium depletion in patients with cardiovascular disease . Am J Med. 1987;262( (suppl 3A) ):11-17.Crossref 36. Ryan MP, Ryan MF, Counihan TB. The effect of diuretics on lymphocyte magnesium and potassium . Acta Med Scand. 1981;647( (suppl) ):153-161. 37. Njinimbam CCG, Ryder KW, Glick MR, Glick SR, Whang R. Identification and treatment of hypomagnesemia and hypokalemia in patients receiving digoxin . Clin Chem. 1990;36:575. 38. Ryan MF, Ryan MP. The effects of magnesium on the binding of H-digoxin to the membranes of intact human red blood cells . Ir J Med Sci. 1983;152:219. 39. Iseri LT, Freed J, Bures AR. Magnesium deficiency and cardiac disorders . Am J Med. 1975;58:837-846.Crossref 40. Firth BG, Yancy CW Jr. Survival in congestive heart failure: have we made a difference? Am J Med. 1990;80:1-3N. 41. Iseri LT, Fairshter RD, Hardemann JL, Brodsky MA. Magnesium and potassium therapy in multifocal atrial tachycardia . Am Heart J. 1985;110:789-794.Crossref 42. Abraham AS, Eylath U, Weinstein M, Czaczkes E. Serum magnesium levels in patients with acute myocardial infarction . N Engl J Med. 1977;296:862-863.Crossref 43. Dyckner T. Serum magnesium in acute myocardial infarction . Acta Med Scand. 1980;207:59-66.Crossref 44. Rasmussen HS. Clinical intervention studies on magnesium in myocardial infarction . Magnesium. 1989;8:316-325. 45. Flink EB, Brick JE, Shane SR. Alterations of long chain free fatty acid and magnesium concentrations in acute myocardial infarction . Arch Intern Med. 1981;141:441-443.Crossref 46. Abraham AS, Rosemann D, Kramer M, et al. Magnesium in the prevention of lethal arrhythmias in acute myocardial infarction . Arch Intern Med. 1987;147:753-755.Crossref 47. Casey B, Counihan TB, Ryan MP. The effects of anoxia and amelioration on 28Mg efflux in cultured cardiac cell line . Ir J Med Sci. 1988;157:360-361. 48. Dyckner T, Wester PO. Effects of magnesium infusion in diuretic induced hyponatremia . Lancet. 1981;1:585-586.Crossref 49. Dorup I, Skajaa K, Clausen T, Kjeldsen K. Reduced concentrations of potassium, magnesium and sodium-potassium pumps in human skeletal muscle during treatment with diuretics . BMJ. 1988;296:455-458.Crossref 50. Dorup I, Skajaa K, Thybo NC. Is it possible to restore the reduced concentrations of Mg, K and Na, K-pumps in muscle seen during long term diuretic treatment by an oral supplement of Mg? Presented at the Third European Congress on Magnesium; March 15, 1990; Geneva, Switzerland. 51. Whang R, Welt LG. Observations in experimental magnesium depletion . J Clin Invest. 1963;42:305-313.Crossref 52. Estep HL, Shaw WA, Watlington C, Hofe R, Holland W, Tucker S. Hypocalcemia due to hypomagnesemia and reversible parathyroid unresponsiveness . J Clin Endocrinol. 1969;29:842-848.Crossref 53. Massry SG. Pharmacology of magnesium . Ann Rev Pharmacol Toxicol. 1977;17:67-82.Crossref 54. Boyd JC, Bruns DE, Wills MR. Frequency of hypomagnesemia in hypokalemic states . Clin Chem. 1983;29:178-179. 55. Whang R, Aikawa JK. Magnesium deficiency and refractoriness to potassium repletion . J Chronic Dis. 1977;30:65-68.Crossref 56. Whang R, Flink EB, Dyckner T, Wester PO, Aikawa JK, Ryan MP. Magnesium depletion as a cause of refractory potassium repletion . Arch Intern Med. 1985;145:1686-1689.Crossref 57. Whang R, Ryder KW. lonicdisturbances in hospital practice: the case for magnesium . Magnesium Bull. 1990;12:122-126. 58. Skou JC. The influence of some cations in an adenosine triphosphatase from peripheral nerves . Biochem Biophys Acta. 1957;23:394-401.Crossref 59. Schilling K, Bornig H, Cumme G, Hoppe H. Effect of magnesium-dependent cell membrane alterations on the transport of K+ in Ehrlich ascites tumor cells . Acta Biol Med Ger. 1980;39:177-184. 60. Borchgrevink PC, Ryan MP. The effects of magnesium, ouabain and bumetanide on rubidium uptake in human atrial cell line . Br J Pharmacol. 1988;95:614-618.Crossref 61. Ryan MP. The role of magnesium in potassium deficiency . In: Whelton P, Whelton A, Walker WG, eds. Potassium in Cardiovascular and Renal Medicine, Arrhythmias, Myocardial Infarction and Hypertension . New York, NY: Marcel Dekker Inc; 1986;2:23-42. 62. Flatman PW. Regulation of potassium transport by magnesium . In: Reuss L, Russell JM, Szabo G, eds. Regulation of Potassium Transport Across Biological Membranes . Austin, Tex: University of Texas Press; 1990;9:191-212. 63. Matsuda H. Open-state substructure of inwardly rectifying potassium channels revealed by magnesium block in guinea-pig heart cells . J Physiol. 1988;397:237-258. 64. Vandenberg CA. Internal rectification of a potassium channel in cardiac ventricular cells depends on internal magnesium ions . Proc Natl Acad Sci U S A. 1987;84:2560-2564.Crossref 65. Ryan MP, Whang R, Yamalis W. Effect of magnesium deficiency on cardiac and skeletal muscle potassium during dietary potassium restriction . Proc Soc Exp Biol Med. 1973;143:1045-1047.Crossref 66. Whang R, Morosi HJ, Rodgers D, Reyes R. The influence of sustained magnesium deficiency on muscle potassium repletion . J Lab Clin Med. 1967;70:895-902. 67. Ryan MP, Hingerty D. Effects of magnesium deficiency on restoration of potassium and sodium levels in potassium-depleted muscle . Ir J Med Sci. 1969;2:137-140.Crossref 68. Rodriques M, Solanki DL, Whang R. Refractory potassium repletion due to cisplatin-induced magnesium depletion . Arch Intern Med. 1989;149:2592-2594.Crossref 69. Shils ME. Experimental human magnesium depletion . Medicine. 1969;48:61-85.Crossref 70. Baehler RW, Work J, Kotchen TA. Studies in the pathogenesis of Bartter's syndrome . Am J Med. 1980;69:933-938.Crossref 71. Gullner JG, Gill JR, Bartter FC. Correction of hypokalemia by magnesium repletion in familial hypokalemic alkalosis with tubulopathy . Am J Med. 1981;71:578-589.Crossref 72. Webb S, Schade DS. Hypomagnesemia as a cause of persistent hypokalemia . JAMA. 1975;233:23-24.Crossref 73. Whang R, Whang DD, Ryder KW, Oei TO. Routine serum magnesium determination: a contemporary clinical imperative . Magnesium Res. 1990;3:267-270. 74. Flink EB. Therapy of magnesium deficiency . Ann N Y Acad Sci. 1969;162:901-905.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1992

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