Division of Nephrology and Hypertension, Department of Internal Medicine, Jared Grantham Kidney Institute, University of Kansas Medical Center, Kansas City, Kansas.
Division of Nephrology and Hypertension, Department of Internal Medicine, Jared Grantham Kidney Institute, University of Kansas Medical Center, Kansas City, Kansas.
Am J Kidney Dis. 2024 Jun;83(6):803-815. doi: 10.1053/j.ajkd.2023.10.017. Epub 2024 Feb 17.
Magnesium is ubiquitous in nature. It sits at the origin of the food chain, occupying the center of chlorophyl in plants. In humans, magnesium is critical to diverse molecular and catalytic processes, including energy transfer and maintenance of the genome. Despite its abundance, hypomagnesemia is common and often goes undiagnosed. This is in spite of epidemiologic data linking low magnesium with chronic diseases including diabetes mellitus. Clinically significant hypermagnesemia is encountered less frequently, but the presentation may be dramatic. Advances in molecular biology and the elucidation of the genetic causes of magnesium disorders have enhanced our understanding of their pathophysiology. Treatment approaches are also changing. The repurposing of newer medications, such as sodium/glucose cotransporter 2 inhibitors, offers new therapeutic options. In this review we integrate knowledge in this rapidly evolving field to provide clinicians and trainees with a resource for approaching common clinical scenarios involving magnesium disorders.
镁在自然界中无处不在。它处于食物链的源头,占据着植物叶绿素的中心。在人体中,镁对包括能量转移和基因组维护在内的多种分子和催化过程至关重要。尽管镁的含量丰富,但低镁血症很常见,且常常未被诊断。尽管有流行病学数据表明,镁含量低与包括糖尿病在内的慢性疾病有关。临床上较少遇到有显著意义的高镁血症,但临床表现可能很明显。分子生物学的进步和镁代谢紊乱的遗传原因的阐明增强了我们对其病理生理学的理解。治疗方法也在发生变化。新型药物(如钠/葡萄糖共转运蛋白 2 抑制剂)的重新应用为治疗提供了新的选择。在这篇综述中,我们整合了这一快速发展领域的知识,为临床医生和受训者提供了一个资源,以处理涉及镁代谢紊乱的常见临床情况。