Improving diagnosis and treatment of hypomagnesemia.

Carlos Leiva-Salinas, Maria Salinas, Maite López-Garrigós, Emilio Flores

Journal: Clinical chemistry and laboratory medicine 2023;62(2):234-248

PMID: 37503587

Abstract

Magnesium is one of the most abundant cations in the body and acts as a cofactor in more than 600 biochemical reactions. Hypomagnesemia is a highly prevalent condition, especially in subjects with comorbid conditions, but has received less attention than other electrolyte disturbances. This review will discuss magnesium physiology, absorption, storage, distribution across the body, and kidney excretion. After reviewing the regulation of magnesium homeostasis, we will focus on the etiology and clinical presentation of hypomagnesemia. The role of laboratory medicine in hypomagnesemia will be the main purpose of this review, and we will discuss the laboratory tests and different samples and methods for its measurement. Although free magnesium is physiologically active, total serum magnesium is the most commonly used measurement in laboratory medicine and is apt for clinical purposes; however, it is not appropriately used, and many patients with hypomagnesemia remain undiagnosed and not treated. Using information technologies, laboratory medicine can largely improve the diagnosis and treatment of hypomagnesemia through the design and establishment of automatic demand management and result management interventions by acting in the first and last steps of the laboratory cycle, test requests, and actions taken after test results, to unmask patients with hypomagnesemia and improve the number of patients undergoing treatment.

© 2023 Walter de Gruyter GmbH, Berlin/Boston.

Address: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain.; Department of Biochemistry and Molecular Biology, Universidad Miguel Hernandez, San Juan de Alicante, Spain.; CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; Department of Clinic Medicine, Universidad Miguel Hernández, San Juan de Alicante, Spain.; Department of Radiology, University of Missouri, Columbia, MO, USA.

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