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Magnesium homeostasis following chemotherapy with cisplatin: A prospective study

  • A.F. Stewart
    Correspondence
    Reprint requests: Andrew F. Stewart, M.D., Fitkin 106, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510.
    Affiliations
    Department of Medicine, the West Haven Veterans Administration Medical Center, West Haven, Connecticut

    The Departments of Internal Medicine and Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut
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  • T. Keating
    Affiliations
    Department of Medicine, the West Haven Veterans Administration Medical Center, West Haven, Connecticut

    The Departments of Internal Medicine and Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut
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  • P.E. Schwartz
    Affiliations
    Department of Medicine, the West Haven Veterans Administration Medical Center, West Haven, Connecticut

    The Departments of Internal Medicine and Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut
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      Abstract

      Retrospective studies suggest that cisplatin chemotherapy regularly leads to hypomagnesemia and occasionally hypocalcemia. The hypomagnesemia has been attributed to renal magnesium wasting. We examined prospectively the incidence of hypomagnesemia, magnesuria, and hypocalcemia in 17 patients receiving chemotherapy with cisplatin. Hypomagnesemia was found in 53% to 88% of patients, depending on the definition of hypomagnesemia. All displayed inappropriate renal excretion of magnesium. Hypocalcemia occurred in one of the 17 prospectively studied patients (5.8%) and in three additional retrospective patients. Hypocalcemic patients demonstrated lower serum magnesium values, higher fractional magnesium excretion, and evidence for reduced intestinal magnesium absorption. We conclude that hypomagnesemia, renal magnesium wasting, and hypocalcemia occur frequently among patients receiving cisplatin. Hypocalcemia occurs in those patients who have the severest renal magnesium wasting, the severest hypomagnesemia, and inadequate intestinal magnesium absorption.

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      References

        • Hill JB
        • Blachley JD
        • Trotter M
        Hypomagnesemia, hypocalcemia, and hypokalemia with cis-platinum therapy [Abstract].
        Clin Res. 1978; 26: 780
        • Pratt CB
        • Hayes FA
        • Green AA
        • et al.
        Phase II pharmacokinetic study of cis-platinum diaminedichloride (CPDD) in children with solid tumors [Abstract C-290]. American Society of Clinical Oncology, New Orleans, Louisiana1979: 361 (fifteenth annual meeting, May)
        • Schilsky RL
        • Anderson T
        • Weiss RB
        Hypomagnesemia and renal magnesium wasting in patients receiving cisdiamine dichlorplatinum II (DPP) [Abstract C-261]. American Society of Clinical Oncology, New Orleans, Louisiana1979: 354 (fifteenth annual meeting, May)
        • Schilsky RL
        • Anderson T
        Hypomagnesemia and renal magnesium wasting in patients receiving cisplatin.
        Ann Intern Med. 1979; 90: 929-931
        • Lyman NW
        • Hemalatha C
        • Viscuso RL
        • Jacobs MG
        Cisplatin-induced hypocalcemia and hypomagnesemia.
        Arch Intern Med. 1980; 140: 1513-1514
        • Schilsky RL
        • Barlock A
        • Ozols RF
        Persistent hypomagnesemia following cisplatin chemotherapy for testicular cancer.
        Cancer Treat Rep. 1982; 66: 1767-1769
        • Macaulay VM
        • Begent RHJ
        • Phillips ME
        • Newlands ES
        Prophylaxis against hypomagnesemia induced by cis-platinum combination chemotherapy.
        Cancer Chemother Pharmacol. 1982; 9: 179-181
        • Ashraf M
        • Scotchel PL
        • Krall JM
        • Flink EB
        Cis-platinuminduced hypomagnesemia and peripheral neuropathy.
        Gynecol Oncol. 1983; 16: 309-318
        • Dirks JH
        The kidney and magnesium regulation.
        Kidney Int. 1983; 23: 771-777
        • Rude RK
        • Singer FR
        Magnesium deficiency and excess.
        Ann Rev Med. 1981; 32: 245-259
        • Wacker WEC
        • Paris AF
        Magnesium metabolism.
        N Engl J Med. 1968; 278: 658-663
        • Agus ZS
        • Wasserstein A
        • Goldfarb S
        Disorders of calcium and magnesium homeostasis.
        Am J Med. 1982; 72: 473-488
        • Rude RK
        • Bethune JE
        • Singer FR
        Renal tubular maximum for magnesium in normal, hyperparathyroid, and hypoparathyroid man.
        J Clin Endocrinol Metab. 1980; 51: 1425-1431
        • Sutton RAL
        • Marichak V
        • Wong NLM
        • Dirks JH
        Cis-platin-induced hypermagnesuria and hypercalciuria in rats [Abstract]. American Society for Bone and Mineral Research, San Antonio, Texas1983: A-24 (fifth annual meeting, June)
        • Rude RK
        • Oldham SB
        • Singer FR
        Functional hypoparathyroidism and parathyroid hormone end organ resistance in human magnesium deficiency.
        Clin Endocrinol. 1976; 5: 209-224
        • Anast C
        • Mohs JM
        • Kaplan SL
        • Burns TW
        Evidence for parathyroid failure in magnesium deficiency.
        Science. 1977; 177: 606-608
        • Suh SM
        • Tashjian AH
        • Matsuo N
        • Parkinson DK
        • Fraser D
        Pathogenesis of hypocalcemia in primary hypomagnesemia: normal end organ responsiveness to parathyroid hormone, impaired parathyroid gland function.
        J Clin Invest. 1973; 52: 153-160
        • Duran MJ
        • Borst GC
        • Osburne RC
        • Eil CE
        Concurrent renal hypomagnesemia and hypoparathyroidism with normal parathormone responsiveness.
        Am J Med. 1984; 76: 151-154