From the Research
Metabolic acidosis, characterized by low bicarbonate levels, can indeed contribute to the development of hypomagnesemia. The relationship between metabolic acidosis and hypomagnesemia is complex, involving the kidneys' response to acidosis, which can lead to increased excretion of magnesium ions 1. Additionally, acidosis can affect the protein binding of magnesium, potentially reducing the amount of biologically active magnesium in the bloodstream. This relationship is particularly notable in conditions like diabetic ketoacidosis and alcoholic ketoacidosis, where both acidosis and magnesium deficiency commonly occur together. The severity of hypomagnesemia depends on the underlying cause and duration of the acidosis. Some studies suggest that hypomagnesemia is frequently encountered in hospitalized patients, with various underlying causes, including malnutrition, drugs, and acid-base disorders 1. Patients with metabolic acidosis should have their magnesium levels monitored, especially if they exhibit symptoms like muscle weakness, tremors, or cardiac arrhythmias. Treatment typically involves addressing the underlying cause of acidosis while simultaneously correcting magnesium deficiency, often through oral supplementation or intravenous replacement in more severe cases. It's essential to note that the development of hypomagnesemia can be multifactorial, and its management should be tailored to the individual patient's needs, taking into account the underlying cause and the presence of other electrolyte and acid-base abnormalities 2, 1. In clinical practice, it's crucial to prioritize the monitoring and management of magnesium levels in patients with metabolic acidosis to prevent complications associated with hypomagnesemia.