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接受紧急血液透析的高镁血症患者的特征。

The characteristics of patients with hypermagnesemia who underwent emergency hemodialysis.

作者信息

Nishikawa Mana, Shimada Noriaki, Kanzaki Motoko, Ikegami Tetsunori, Fukuoka Toshio, Fukushima Masaki, Asano Kenichiro

机构信息

Department of Nephrology Kurashiki Central Hospital Kurashiki Japan.

Department of Emergency Medicine Kurashiki Central Hospital Kurashiki Japan.

出版信息

Acute Med Surg. 2018 Feb 21;5(3):222-229. doi: 10.1002/ams2.334. eCollection 2018 Jul.

Abstract

AIM

This study aimed to clarify the characteristics of patients who presented with severe hypermagnesemia and subsequently underwent emergency hemodialysis.

METHODS

We investigated the age, gender, complications, clinical symptoms, causal drugs, electrocardiogram findings, and laboratory data of 15 patients.

RESULTS

Magnesium oxide had been administered in all cases and 14 patients were over 65 years old. The male : female ratio was 6:9. Chief complaints included a disturbance of consciousness, hypotension, bradycardia, and respiratory failure. The median serum magnesium value before hemodialysis was 6.0 (3.7-18.6) mg/dL. The daily dosage of magnesium oxide was ≤ 2.0 g in 12 cases. The median serum creatinine value before hemodialysis was 5.39 (0.54-10.29) mg/dL. However, in two cases, the creatinine value was not elevated. Complications of acute kidney injury exacerbated the hypermagnesemia in nine cases.

CONCLUSIONS

We recommend that the serum magnesium value should be measured in older patients who are taking magnesium oxide and are showing signs and symptoms of a disturbance of consciousness, hypotension, bradycardia, and respiratory failure of an uncertain etiology, even if the serum creatinine value is not elevated or the dosage of magnesium oxide is within recommended levels.

摘要

目的

本研究旨在阐明出现严重高镁血症并随后接受紧急血液透析的患者的特征。

方法

我们调查了15例患者的年龄、性别、并发症、临床症状、致病药物、心电图结果及实验室数据。

结果

所有病例均使用了氧化镁,14例患者年龄超过65岁。男女比例为6:9。主要症状包括意识障碍、低血压、心动过缓和呼吸衰竭。血液透析前血清镁值中位数为6.0(3.7 - 18.6)mg/dL。12例患者氧化镁日剂量≤2.0g。血液透析前血清肌酐值中位数为5.39(0.54 - 10.29)mg/dL。然而,有2例患者肌酐值未升高。急性肾损伤并发症在9例患者中加重了高镁血症。

结论

我们建议,对于服用氧化镁且出现意识障碍、低血压、心动过缓和病因不明的呼吸衰竭体征及症状的老年患者,即使血清肌酐值未升高或氧化镁剂量在推荐水平内,也应检测血清镁值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b126/6028801/552d5ad9d404/AMS2-5-222-g001.jpg

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