Bartter Syndrome Suggested by Polyuria and Nocturia
Presentation
A 6-year-old boy who is developmentally delayed is brought to your office because he has been experiencing polydipsia, nocturia, and polyuria for several months. He is 3 to 4 years delayed in language, motor, and social skills. Physical examination reveals a healthy-looking child whose height and weight are between the 5th and 10th percentiles. All vital signs are normal, and no abnormalities are found on complete physical examination.
Bartter Syndrome, Diagnosis in Children
Bartter syndrome is a rare form of renal potassium wasting characterized by hypokalemia, normal blood pressure, vascular insensitivity to pressor agents, and elevated plasma concentrations of renin and aldosterone. In certain families, the disorder may be inherited as an autosomal recessive trait.
Magnesium and Potassium Balance
Magnesium repletion and its effect on potassium homeostasis in critically ill adults: Results of a double-blind, randomized, controlled trial
Objectives: The aims of this study were to evaluate the safety and efficacy of magnesium replacement therapy and to determine its effect on potassium retention in hypokalemic, critically ill patients.
Magnesium and Electrolytes in Head Injury Cases
Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury
Objective: Low serum levels of electrolytes such as magnesium (Mg), potassium (K), calcium (Ca), and phosphate (P) can lead to a number of clinical problems in intensive care unit (ICU) patients, including hypertension, coronary vasoconstriction, disturbances in heart rhythm, and muscle weakness.
Magnesium and Potassium Interaction
The following references strongly support the need to correct Mg deficiency in order to correct potassium serum levels. While the type of MgD present in the following are serum Mg, and since normomagnesemia MgD has not been studied, it seems prudent to me that all types of MgD should be maximally treated if KD is present..
Magnesium Balance
INTRODUCTION
Magnesium (Mg) is an essential cofactor for more than 300 separate enzymes within the human body. Thus know to be “indispensable to the metabolism of ATP, which means that it is essential in a great many metabolic processes such as glucose utilization; synthesis of fat, protein, and nucleic acids; muscle contraction; and some membrane transport systems.”(1) Those desirous of learning more about Mg should read the excellent short review by Elin.(2)
Phosphorus, Calcium and Magnesium Interactions
by Herbert C. Mansmann, Jr., M.D.
Phosphorus is the second most abundant element of the human body. About 80% is in bones. The RDA is 700 mg/day, and the regular diet contains 1026 mg in women and 1455 in men. Phosphorus is present as phosphate in biologic systems. It is the concentration of elemental (or inorganic) phosphorus that is measured in the clinical laboratory, although the terms phosphorus and phosphate tend to be used interchangeably.
The Role of Zinc in Magnesium Deficiencies
by Herbert C. Mansmann, Jr. M.D.
As a child in the 1920’s, Zinc (Zn) oxide was our antibiotic ointment for all sorts of skin conditions. As a pediatrician in the 1950’s, it was still the treatment of choice for infected diaper rashes. Recently Zn lozenges have become the treatment for symptoms of the common cold, although meta-analysis of multiple clinical studies has not borne this out as being effective. Most common cold viruses grow and reside in the nose, not in the throat, so this analysis should not be unsuspected. Yet Zn is very safe and if it seems to work for you, I would recommend that one continue to use the lozenges.
Magnesium Supplementation Dosing
by Herbert C. Mansmann, Jr. M.D.
NORMAL MAGNESIUM (Mg) INTAKE
1. The Recommended Daily Allowance (RDA) for Mg is between 350 and 450 milligrams (mg) - (6mg per kg per day). One pound of spinach and its cooking water a day will meet this requirement for a normal adult. Green vegetables with their chlorophyll, which contains Mg are good choices, as are nuts, legumes, unpolished rice, and whole grains. But the American diet contains too many refined ingredients. If you are pregnant or ill 600 mg of Mg/day - (10 mg/kg/day), is usually required.
Magnesium and the Heart
by Herbert C. Mansmann, Jr. M.D.
It has been known since the 1950s that alcohol is magnesuretic, causes loss of magnesium in the urine and it was suggested that alcoholics needed 7-10 mg/kg/day of Mg, rather than the recommended 6 mg/kg/day. It has since been demonstrated that they need more also because of a decreased oral Mg dietary intake. (Seelig, 1980).