CKD and Low Magnesium: Pay Attention

Lynda Szczech, MD


February 06, 2013

In This Article

The Study and Background

The Study

Khan AM, Lubitz SA, Sullivan LM, et al. Low serum magnesium and the development of atrial fibrillation in the community: the Framingham Heart Study. Circulation. 2013;127:33-38.


Nephrologists do not frequently discuss serum magnesium as a clinical subject. With the exception of a very small proportion of patients with chronic kidney disease (CKD) who waste magnesium through their tubules due to medication toxicity, such as amphotericin, the vast majority of CKD patients will retain magnesium to some small and usually clinically insignificant extent. Because of this, it is nearly universally taught by nephrologists to house staff to avoid antacids and intestinal preparations containing magnesium for persons on dialysis.

While complications of both hypo- and hypermagnesemia exist, their relative infrequency among persons with kidney disease has reinforced a very limited practice of monitoring magnesium levels. However, recent studies have demonstrated that low serum magnesium has been linked to an increased risk for atrial fibrillation after cardiac surgery.[1]