Abstract
A discussion of diuretic action on magnesium excretion is usually preceded by a short review of overall homeostasis and renal handling of magnesium. Magnesium is the fourth most abundant cation in the human body and the second most common cation in the intracellular fluid next to potassium. The adult human body contains 21–28 g of magnesium [1]. The plasma magnesium concentration ranges from 0.7 to 1.0 mmol/liter in normal subjects. Approximately 2% of the total body magnesium is located in extracellular compartments. The major magnesium pool is almost exclusively intracellular; approximately 65% is found in the bone, 20% in the muscle and 11% in the nonmuscle soft tissue. Intracellular magnesium plays a vital role in many cell processes, including production and utilization of energy as the membrane bound Mg-activated adenosine triphosphatase [2, 3]. Extracellular magnesium is implicated in neuronal control, neuromuscular transmission and cardiovascular tone [4]. In man, approximately 30%–40% of dietary absorption takes place in the small intestine, less in the duodenum than in the ileum [5].
Preview
Unable to display preview. Download preview PDF.
References
Widdowson EM et al. (1951) Chemical composition of human body. Clin Sci 10: 113
Skou JC (1957) The influence of some cations on an adenosine triphosphatase from peripheral nerves. Biochem Biophys Acta 23: 394
Skou JC (1960) Further investigations on a Mg++ Na+ activated adenotriphosphatase, possibly related to the active transport of Na+ K+ across the nerve membrane. Biochem Biophys Acta 42: 6
Altura BM, Altura BT (1981) Role of magnesium ions in contractility of blood vessels and skeletal muscles. Magnesium Bull 1a: 102
Peerenboom H, Vormann S, Keek E, Strohmeyer S (1980) Intestinale Absorption von Mg. I Messung des Mg-Transport im Jejunum des Menschen. Magnesium Bull 2: 3
Wen SF et al (1971) Evidence for renal magnesium secretion during magnesium infusion in the dog. Am J Physiol 220: 33
Carney SL et al (1980) Effect of magnesium deficiency on renal magnesium and calcium transport in the rat. J Clin Invest 65: 180
Quamme GA, Dirks JH (1985) Magnesium: cellular and renal exchanges. In: Seldin DW, Giebisch G (eds) The kidney physiology and pathophysiology. Raven, New York
Shareghi GR, Agus ZS (1982) Magnesium transport in the cortical thick ascending limb of Henle’s loop of the rabbit. J Clin Invest 65: 759
Quamme GA (1982) Effect of hypercalcemia on renal tubular handling of calcium and magnesium. Can J Physiol Pharmacol 60: 1275
Shareghi GR, Agus ZS (1979) PTH - sensitive magnesium transport in the rabbit cortical thick ascending limb ov Henle. (CTAL) Kidney Int 16:S37A
Wong NLM, Quamme GA, Dirks JH (1984) Influence of bicarbonate on the renal handling of magnesium. In: Smith LH, Robertson WG, Finleyson B (eds) Urolithiasis clinical and basic research. Plenum, New York
Carney SL, Wong NLM, Quamme GA, Dirks (1980) Effect of magnesium deficiency on renal magnesium and calcium transport in the rat. J Clin Invest 65: 180
Quamme GA, Carney SL, Wong NLM, Dirks JH (1980) Effect of parathyroid hormone on renal calcium and magnesium reabsorption in magnesium deficient rats. Pflugers Arch 386: 59
Bergstrom J, Hultman E, Solheim SB (1973) The effect of mefruside on plasma and muscle electrolyte and blood pressure in normal subject and in patients with essential hypertension. Acta Medica Scan 194: 427
Wester PO, Dyckner T (1981) Diuretic treatment and magnesium losses. Acta Medica Scan 647 (Suppl.) 145
Lim P, Jacob E (1972) Magnesium deficiency in patients on long term diuretic therapy for heart failure. Br Med J 3: 620
Barker ES, Elkintoa JR, Clark JK (1959) Studies on the renal excretion of magnesium in man. J Clin Invest 38: 1733
Wesson LG Sr (1962) Magnesium, calcium and phosphate excretion during osmotic diuresis in the dog. J Lab Clin Med 60: 422
Wong NLM, Quamme GA, Sutton RAL, Dirks JH (1979) Effects of mannitol on water and electrolyte transport in the dog kidney. L Lab Clin Med 94: 683
Wong NLM, Quamme GA, Dirks JH (1981) Effects of urea on electrolyte transport in the dog kidney. J Lab Clin Med 98: 741
Lemann J Jr, Lennon EJ, Piering WR, Prien EL, Ricanati RS (1970) Evidence that glucose ingestion inhibits net renal tubular reabsorption of calcium and magnesium in man. J Lab Clin Med 75: 578
Lennon EJ, Lemann J Jr, Piering WF, Larson LS (1974) The effect of glucose on urinary cation excretion during chronic extracellular volume expansion in normal man. J Clin Invest 53: 1424
Roy DR, Seely JF (1984) Effect of glucose on renal excretion of eletrolytes in the rat. Am J Physiol 240: F17
Seeham J, White A (1982) Diuretic associated hypomagnesuria. Br Med J 285: 157
Antoniou LD, Eisner DGM, Slotkoff N, Lillienfield LS (1969) Relationship between sodium and calcium transport in the kidney. J Lab Clin Med 74: 410
Duarte CG (1968) Effects of ethacrynic acid and furosemide on urinary calcium, phosphate, and magnesium. Metab Clin Exp 17: 867
Sotornik I, Schuck IO, Stribina J (1969) Influence of diuretics on renal calcium excretion. Experientia 25: 591
Walser M (1973) Divalent cations: physicochemical state in glomerular filtrate and urine and renal excretion. In: Orloff J, Berliner RW (eds) Handbook of physiology. Renal physiology. Physiological Societ, pp 555–586
Quamme GA (1981) Effect of furosemide on calcium and magnesium transport in the rat nephron. Am J Physiol 241: 340
Loew D, Meng K (1977) The renal mechanism of Bay g 2821. Pharmatherapeutica 1: 333–340
Reyes AJ, Leary WP (1984) Diuretics and magnesium. Magnesium Bull 6 (3): 87
Duarte CG (1968) Effect of chlorothiazide and amipramizide (MK 870) on the renal excretion of calcium, phosphate and magnesium. Metabolism 17: 420
Eknoyan G, Suki N, Martinez-Maldonade M (1970) Effect of diuretics on urinary excretion of phosphate, calcium and magnesium in thyroparathyroidectomized dogs. J Lab Clin Med 76: 257
Jorgensen FS, Transbol I (1973) The effect of bendroflumethiazide on the renal handling of calcium, magnesium and phosphate in normocalcemic renal stone formers and inyperparathy-roidism. Acta Med Scan 194: 327
Quamme GA, Wong NLM, Sutton RAL, Dirks JH (1975) Interrelationship of chlorothiazide and parathyroid hormone: a micropuncture study. Am J Physiol 229: 200
Wong NLM, Quamme GA, Dirks JH (1982) Hypocalciuric action of chlorothiazide in thy-roparathyroidectomized hamster. Can J Physiol Pharmacol 60: 1160
Parfitt AM (1972) The interactions of thiazide diuretics with parathyroid hormone and vitamin D. Studies in patients with hypoparathyroidism. J Clin Invest 51: 1879
Williams GH, Samata JK (1978) Interrelationships among thiazide diuretics and calcium, magnesium, sodium and potassium balance in normal and hypertensive man. J Clin Pharm 18: 530
Wacker WEC (1961) The effect of hydrochlorothiazide on magnesium excretion. J Clin Invest 40: 1086
Reyes AJ, Acosta-Barrios TN, Leary WP, van der Byl K (1983) The antihypertensive effect of indapamide. S Afr Med J 63: 804
Reyes AJ, Leary WP, van der Byl K (1983) Urinary magnesium output and flow after monodosing healthy adults with indapamide. S Afr Med J 64: 820
Horton R, Biglieri EG (1962) Effect of aldosterone on the metabolism of magnesium. J Clin Endocrino Metab 22: 1187
Devane J, Ryan MP (1978) The effects of amiloride on urinary plasma and lymphocyte magnesium in congestive heart failure patients. Irish J Med Sei 147: 327
Lim P, Jacob E (1978) Magnesium-saving property of an aldosterone antagonist in the treatment of oedema of liver cirrhosis. Br Med J 1: 755
Devane J, Ryan MP (1982) The effects of amiloride and triamterene on urinary magnesium excretion in conscious saline-loaded rats. Br J Pharmac 72: 285
Devane J, Ryan MP (1980) Reduced renal clearance of magnesium during amiloride administration in rats. Irish J Med Sei 149: 449
Devane J, Ryan MP (1983) Dose-dependent reduction in renal magnesium clearance by amiloride during furosemide-induced diuresis in rats. Br J Pharm 80: 421
Devane J, Ryan MP (1983) Evidence for a magnesium-sparing action of amiloride during renal clearance studies in rats. Br J Pharm 79: 891
Schilsky RL, Barlock A, Ozols RF (1982) Persistent Hypomagnesemia following cisplatin chemotherapy for testicular cancer. Cancer Treat Rep 66: 1767
Brook CGD (1978) Hypomagnesemia, hypocalcemia with hypokalemia caused by treatment with high dose gentamiein. Arch Dis Child 53: 817
Thompson CB, June CH, Sullivan KM, Thomas ED (1984) Association between cyelosporine neurotoxicity and.Hypomagnesemia. Lancet 2 (8412): 1116
Francisco LL, Dibona GF (1974) Mechanism of negative potassium balance in the magnesium deficient rat (Abstract). Kidney Int 16: 852
Wong NLM, Sutton RAL, Mavichak V, Quamme GA, Dirks JH (1985) Enhanced distal absorption of potassium by magnesium-deficient rats. Clin Sci (in press)
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1986 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Dirks, J.H., Wong, N.L.M. (1986). Diuretics and Magnesium Handling. In: Krück, F., Schrey, A. (eds) Diuretika III. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71487-0_14
Download citation
DOI: https://doi.org/10.1007/978-3-642-71487-0_14
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-71489-4
Online ISBN: 978-3-642-71487-0
eBook Packages: Springer Book Archive