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Abstract Disorders of magnesium metabolism are common in hospital patients and are frequently unrecognized. Low magnesium intake may be a contributor to many diseases including diabetes ,cardiovascular disease and osteoporosis while common complications of hypermagnesemia include cardiac arrhythmiasis and hypocalcemia. Studies on monogenetic disorders of Mg2+ wasting have unraveled the molecular details of renal and intestinal Mg2+absorption and consequently whole body Mg2+ homeostasis. As hypomagnesemia is responsible for increased morbidity and mortality, it should be detected and corrected systematically. Hypermagnesemia is relatively infrequent and often iatrogenic, particularly in the case of patients with renal insufficiency, for whom Mg should be prescribed with care, but it can lead to cardiovascular and neuromuscular manifestations. Early recognition of disorderd magnesium metabolism and correction of the electrolyte imbalance is necessary to avoid these complications. Magnesium is used for its antiarrhythmic properties in treating torsades de pointes and arrhythmias induced by digitalis. Its role in the treatment of asthmatic attacks and myocardial infarction needs to be defined more precisely. Magnesium has an established role in obstetrics and an evolving role in other clinical areas, in particular cardiology. Many of the effects involving magnesium are still a matter of controversy. No single method is satisfactory to assess magnesium status. The simplest, most useful and readily available tests are the measurement of serum total magnesium and the magnesium tolerance test. Ionised magnesium measurement may become more readily available with the development of reliable analysers. The availability, cost and safety of magnesium treatment deserve emphasis. In brief, this agent is safe (no life threatening side effects noted in any of the trials), inexpensive, and familiar to most physicians. |