Oral magnesium pidolate: effects of long-term administration in patients with sickle cell disease

Prevention of erythrocyte dehydration by specific blockade of the transport pathways promoting loss of potassium (K) is a potential therapeutic strate gy for sickle cell (SS) disease. Dietary magnesium (Mg) pidolate supplement ation over a 4-week period has been shown to inhibit K-Cl co-transport and reduce dehydration. We report here the results in 17 of 20 patients with SS disease treated in an open-label unblinded study of the effects of long-te rm (6 months) oral Mg pidolate administration (540 mg Mg/d). A significant decrease (P < 0.0025) was observed with Mg therapy in the distribution widt hs for red cell mean cell haemoglobin concentration (MCHC) (haemoglobin dis tribution width; HDW), reticulocyte mean cell volume (red cell distribution width of reticulocytes; RDWr) and MCHC (reticulocyte HDW; HDWr), activity of red cell K-Cl co-transport, Na/Mg exchanger and Ca2+-activated (Gardos) K+ channel, whereas red cell K and Mg contents were significantly increased . Hb levels and absolute reticulocyte counts did pat change with Mg therapy . Two patients did not complete the trial because of diarrhoea and one did not complete the trial for unrelated reasons. Although the median number of painful days in a 6-month period decreased from IS (range 0-60) in the yea r before the trial to 1 (range 0-18; P < 0.0005) during the period of Mg th erapy, no firm conclusion on therapeutic efficacy could be drawn from this unblinded open-label trial.