Hypomagnesemia in the Cancer Patient

Hypomagnesemia is a common medical problem that contributes to the morbidity and mortality of patients with cancer. This review summarizes magnesium physiology and highlights the mechanisms underlying magnesium disturbances due to cancer and cancer treatment. The causes of hypomagnesemia can be cate...

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Bibliographic Details
Published inKidney360 Vol. 2; no. 1; pp. 154 - 166
Main Authors Workeneh, Biruh T, Uppal, Nupur N, Jhaveri, Kenar D, Rondon-Berrios, Helbert
Format Journal Article
LanguageEnglish
Published United States American Society of Nephrology 28.01.2021
Subjects
Antineoplastic Agents - adverse effects
Humans
Kidney
Magnesium - therapeutic use
Neoplasms - complications
Review
acid/base and electrolyte disorders
hypomagnesemia
cetuximab
magnesium
onconephrology
cisplatin
electrolytes
neoplasms
TRPM6
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Summary:Hypomagnesemia is a common medical problem that contributes to the morbidity and mortality of patients with cancer. This review summarizes magnesium physiology and highlights the mechanisms underlying magnesium disturbances due to cancer and cancer treatment. The causes of hypomagnesemia can be categorized according to the pathophysiologic mechanism: decreased intake, transcellular shift, gastrointestinal losses, and kidney losses. Patients with cancer are at risk for opportunistic infections, frequently experience cardiovascular complications, and often receive classes of medications that cause or exacerbate hypomagnesemia. Also, cancer-specific therapies are responsible for hypomagnesemia, including platinum-based chemotherapy, anti-EGF receptor mAbs, human EGF receptor-2 target inhibitors (HER2), and calcineurin inhibitors. Urinary indices, such as the fractional excretion of magnesium, can provide useful information about the etiology. The management of hypomagnesemia depends on the magnitude of hypomagnesemia and the underlying cause. We recommended checking serum magnesium at the beginning of treatment and as part of routine monitoring throughout cancer treatment. Opportunities exist for potential research and practice improvement, including further characterization of hypomagnesemia regarding the clinical effect on cancer outcomes, preventing hypomagnesemia in patients receiving high-risk anticancer agents, and developing effective therapeutic strategies.
ISSN:2641-7650
2641-7650
DOI:10.34067/kid.0005622020