Abstract
Background
Hypokalemia is a common disorder that can negatively affect organ function. Magnesium
supplementation is frequently recommended despite limited evidence to support its
use.
Objectives
The purpose of this study was to evaluate the clinical effects of magnesium coadministration
in patients treated for hypokalemia in the emergency department (ED).
Methods
This retrospective, single-center study evaluated adults treated with intravenous
(i.v.) potassium for hypokalemia (serum potassium <3.5 mMol/L) in the ED between July
1, 2016 and June 30, 2020. Patients given magnesium supplementation within 4 h of
potassium administration (MG+) were compared with those not given concurrent magnesium
(MG−). The primary outcome was time to potassium normalization (≥ 3.5 mMol/L). Secondary
outcomes included clinical effects, adverse effects, and dosing of magnesium and potassium.
Results
Two hundred patients were included (MG+ = 100; MG− = 100). Patients in the MG− group
more frequently had history of myocardial infarction (16% vs. 6%; p = 0.02) and alcoholism (16% vs. 6%; p = 0.02). Patients in the MG+ group had higher incidence of symptomatic hypokalemia
(34% vs. 19%; p = 0.02) and severe hypokalemia (serum potassium < 2.5 mMol/L) (15% vs. 8%; p = 0.03). There were no differences in time to serum potassium normalization, change
in serum potassium after treatment, or incidence of potassium normalization within
24 h of treatment. MG+ patients required more potassium within 24 h of treatment and
more frequently developed hypermagnesemia (serum magnesium >1.1 mMol/L).
Conclusions
Magnesium coadministration during hypokalemia treatment did not affect time to serum
potassium normalization but was associated with more hypermagnesemia.
Keywords
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Article info
Publication history
Published online: June 08, 2022
Accepted:
June 4,
2022
Received in revised form:
May 6,
2022
Received:
February 17,
2022
Footnotes
This work was presented at the Society of Critical Care Medicine Virtual Critical Care Congress in April 2022.
Identification
Copyright
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