PATHOGENETIC MECHANISMS OF HYPOMAGNESEMIA IN ALCOHOLIC PATIENTS

The aim of our study was to describe the possible pathophysiologic mec hanisms of hypomagnesemia in alcoholic patients. A total of 127 chroni c alcoholic patients admitted to our university hospital for causes re lated to alcohol abuse were studied. Hypomagnesemia was the most commo n electrolyte disturbance observed in 38 patients (29.9 %). In 18 of t hem inappropriate magnesiuria was evident, possibly due to hypophospha temia, to metabolic acidosis or to a direct magnesiuric effect of acut e alcohol consumption. The causes of hypomagnesemia in the remaining 2 0 patients were alcohol withdrawal syndrome and diarrhea. Respiratory alkalosis was evident in 10 hypomagnesemic patients and could have pla yed a role in the development of hypomagnesemia. A decreased magnesium intake could also have contributed to the hypomagnesemia, especially in malnourished alcoholic patients. Hypomagnesemic patients more frequ ently had other acid - base and electrolyte abnormalities, such as hyp ophosphatemia, hypokalemia, hypocalcemia, and respiratory alkalosis, a s compared with the normomagnesemic patients. Moreover, in hypomagnese mic patients serum magnesium levels were correlated with the indices o f potassium and phosphorus excretion, suggesting that serum magnesium levels play a central role in the homeostasis of the other electrolyte s. In conclusion, hypomagnesemia is the most common electrolyte abnorm ality observed in alcoholic patients, as a result of various pathophys iologic mechanisms.