Magnesium in cystic fibrosis-Systematic review of the literature

• Published in: Pediatric pulmonology Vol. 51; no. 2; pp. 196 - 202
• Main Authors: Santi, Maristella, Milani, Gregorio P., Simonetti, Giacomo D., Fossali, Emilio F., Bianchetti, Mario G., Lava, Sebastiano A.G.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.02.2016; Wiley Subscription Services, Inc
• Subjects: aminoglycosides; Aminoglycosides - adverse effects; cystic fibrosis; Cystic Fibrosis - drug therapy; Cystic Fibrosis - metabolism; Cystic Fibrosis - physiopathology; Deoxyribonucleases - therapeutic use; Dietary Supplements; Enzyme Replacement Therapy; Expectorants - therapeutic use; Homeostasis; Humans; hypomagnesemia; Intestinal Mucosa - metabolism; Kidney - metabolism; magnesium; Magnesium - metabolism; Magnesium - therapeutic use; Muscle Strength - physiology; Respiratory Muscles - physiopathology; review; Water-Electrolyte Imbalance - chemically induced; Water-Electrolyte Imbalance - metabolism; hypomagnesemia; magnesium; aminoglycosides; cystic fibrosis; review
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.23356

Summary Background The metabolism of sodium, potassium, and chloride and the acid‐base balance are sometimes altered in cystic fibrosis. Textbooks and reviews only marginally address the homeostasis of magnesium in cystic fibrosis. Methods We performed a search of the Medical Subject Headings terms (cystic fibrosis OR mucoviscidosis) AND (magnesium OR hypomagnes[a]emia) in the US National Library of Medicine and Excerpta Medica databases. Results We identified 25 reports dealing with magnesium and cystic fibrosis. The results of the review may be summarized as follows. First, hypomagnesemia affects more than half of the cystic fibrosis patients with advanced disease; second, magnesemia, which is normally age‐independent, relevantly decreases with age in cystic fibrosis; third, aminoglycoside antimicrobials frequently induce both acute and chronic renal magnesium‐wasting; fourth, sweat magnesium concentration was normal in cystic fibrosis patients; fifth, limited data suggest the existence of an impaired intestinal magnesium balance. Finally, stimulating observations suggest that magnesium supplements might achieve an improvement in respiratory muscle strength and mucolytic activity of both recombinant and endogenous deoxyribonuclease. Conclusions The first comprehensive review of the literature confirms that, despite being one of the most prevalent minerals in the body, the importance of magnesium in cystic fibrosis is largely overlooked. In these patients, hypomagnesemia should be sought once a year. Furthermore, the potential of supplementation with this cation deserves more attention. Pediatr Pulmonol. 2016;51:196–202. © 2015 Wiley Periodicals, Inc.