Hypomagnesemia Is Prevalent in Patients Undergoing Gynecologic Surgery by a Gynecologic Oncologist

Ulm, Michael; Watson, Catherine; Vaddadi, P.; Wan, Jim Y.; Santoso, Joseph T.

doi:10.1097/igc.0000000000000766

Cited by 8 publications

(2 citation statements)

References 17 publications

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“…All the clinical effects for the use of magnesium sulfate in anesthesia presented by the anesthesiologists participating in this survey have been reported in other publications, including various systematic reviews and meta-analyses, although some of them are still subjects of controversy Beşogul et al, 2009; Gozdemir et al, 2010; Rhee et al, 2012; Abdulatif et al, 2013; Rotava et al, 2013; Agrawal et al, 2014; Ahsan et al, 2014; Crowther et al, 2014; Kahraman and Eroglu, 2014; Kew et al, 2014; Marzban et al, 2014; Rodrigo et al, 2014; Srebro et al, 2014; Uludag et al, 2014; Berhan and Berhan, 2015; Kim et al, 2015; Safavi et al, 2015; Vigil-De Gracia and Ludmir, 2015; Demiroglu et al, 2016; Green, 2016; Griffiths and Kew, 2016; Jangra et al, 2016; Juibari et al, 2016; Maged et al, 2016; Naghipour et al, 2016; Rodríguez-Rubio et al, 2016, 2017; Soltani et al, 2016; Thomas and Behr, 2016; Ulm et al, 2016; Vendrell et al, 2016; Xie et al, 2016, 2017; Brookfield et al, 2017; Haryalchi et al, 2017; Kutlesic et al, 2017; Lecuyer et al, 2017; McKeown et al, 2017; Mendonca et al, 2017; Salaminia et al, 2018; Zhang et al, 2018.…”

Section: Discussionmentioning

confidence: 99%

Use Profile of Magnesium Sulfate in Anesthesia in Brazil

et al. 2019

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Objectives: The use of magnesium sulfate in the perioperative period has several benefits, including analgesia, inhibition of the release of catecholamines and prevention of vasospasm. The aim of this survey was to provide an overview of the use of magnesium sulfate in anesthesia. Method: This was a prospective descriptive cross-sectional study. An online questionnaire was sent to 9,869 Brazilian anesthesiologists and trainees. The questionnaire comprised closed questions mainly regarding the frequency, clinical effects, adverse events, and doses of magnesium sulfate used in anesthesia. Results: Of the 954 doctors who responded to the survey, 337 (35.32%) reported using magnesium sulfate in anesthesia. The most commonly cited clinical effects for the use of magnesium sulfate in anesthesia were ( n /%): postoperative analgesia (245/72.70%), reduction of anesthetic consumption (240/71.21%) and prevention and treatment of preeclampsia and seizures in eclampsia (220/65.28%). The most frequently reported adverse events were hypotension (187/55.48%), residual neuromuscular blockade (133/39.46%), hypermagnesemia (30/8.90%), and intravenous injection pain (26/7.71%). The intravenous doses of magnesium sulfate used in most general anesthesia inductions were between 30 and 40 mg.kg −1 . Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses.

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Section: Discussionmentioning

confidence: 99%

Use Profile of Magnesium Sulfate in Anesthesia in Brazil

et al. 2019

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“…Therefore, hypomagnesemia remains mostly undiagnosed and untreated, but occurs in up to 15% of the population (4,5). Conditions associated with chronic hypomagnesemia include diabetes mellitus, metabolic syndrome, kidney disease, hypertension, and cancer (6)(7)(8)(9). There is increasing evidence that hypomagnesemia correlates with type 2 diabetes mellitus (T2DM), gestational diabetes, and complications of diabetes such as diabetic nephropathy, retinopathy, foot ulcers, and coronary heart disease (7,(10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Insulin receptor substrate 4 deficiency mediates the insulin effect on the epithelial magnesium channel TRPM6 and causes hypomagnesemia

Zhang

Neelam

et al. 2022

Preprint

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The kidney is the key regulator of magnesium (Mg2+) homeostasis in the human body. In the distal convoluted tubule (DCT), the apical epithelial magnesium (Mg2+) channel TRPM6, determines how much Mg2+ is excreted in the urine. To better understand the regulation of human renal Mg2+ absorption we identified novel, potential interaction partners of TRPM6 by pursuing a liquid chromatography tandem mass spectrometry (LC-MS/MS) proteomics approach. We found insulin receptor substrate 4 (IRS4) enriched with TRPM6 tagged to glutathione S-transferase (TRPM6-GST) but not GST control. Physical interaction between IRS4 and TRPM6 was confirmed by co-immunoprecipitation. Applying microdissection of mouse tubules, we detected Irs4 mRNA expression mostly in the DCT and to a lower degree in the proximal tubule and thick ascending limb of Henle. Given the overall low abundance of Irs4 mRNA along the tubule we investigated the phenotype of Irs4 knockout mice (Irs4-/-). These Irs4-/- mice displayed significantly higher urinary and fecal Mg2+ losses and lower blood Mg2+ levels than wild-type (WT) mice. Claudin-16, claudin-19, and Hnf1b mRNA and Claudin-16 and Trpm6 protein expression was significantly higher in kidneys of 3 month old Irs4-/- mice consistent with a compensatory mechanism to conserve Mg2+. Applying whole-cell patch-clamp recording we confirmed the stimulatory role of insulin on TRPM6 channel activity and showed that IRS4 targets the two TRPM6 phosphorylation sites T1391 and S1583 to enhance TRPM6 current density. To test the effect of Mg2+ deficiency on metabolism, we performed glucose and insulin tolerance studies, which were mildly abnormal in Irs4-/- mice.

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