potassium-magnesium-citrate and Magnesium-Deficiency

The study was performed to ascertain the value of potassium magnesium citrate, magnesium citrate, and potassium citrate in overcoming thiazide-induced hypokalemia and magnesium loss. Sixty-two healthy subjects were first administered hydrochlorothiazide, 50 mg/d. After 3 weeks of thiazide treatment (or earlier for potassium level

Topics: Adult; Citrates; Citric Acid; Diuretics; Drug Combinations; Female; Humans; Hydrochlorothiazide; Hypokalemia; Magnesium Compounds; Magnesium Deficiency; Male; Organometallic Compounds; Potassium Citrate; Potassium Compounds; Sodium Chloride Symporter Inhibitors

The purpose of this study was to compare the efficacy of three dosages of potassium-magnesium citrate in overcoming thiazide-induced hypokalemia and magnesium loss and increasing urinary pH and citrate. Sixty-one normal subjects first took hydrochlorothiazide at 50 mg/d. After 3 weeks of thiazide treatment or earlier if hypokalemia developed, the subjects were randomized to take one of three dosages of potassium-magnesium citrate (K ( 4 ) MgCit ( 2 ) ) for 3 weeks while continuing on the thiazide: 4 tablets per day (24 mEq potassium, 12 mEq magnesium, and 36 mEq citrate per day), 7 tablets per day (49 mEq potassium, 24.5 mEq magnesium, and 73.5 mEq citrate per day), or 10 tablets per day (70 mEq potassium, 35 mEq magnesium, and 105 mEq citrate per day). Outcome measures were changes in serum potassium and magnesium and urinary potassium, magnesium, pH, and citrate. All three dosages of potassium-magnesium citrate significantly increased serum potassium concentration, with >80% of subjects regaining normal values despite continued thiazide therapy. The two higher dosages, but not the lowest dosage, caused a small but significant increase in serum magnesium concentration, while substantially increasing urinary magnesium. All three dosages significantly increased urinary pH and citrate in a dose-dependent manner. The lowest dosage produced increases sufficient to prevent stone recurrence. Side effects of thiazide therapy were ameliorated by the highest dosage but not by the two lower dosages. Potassium-magnesium citrate at a dosage of 4 tablets per day is adequate to correct thiazide-induced hypokalemia and to increase urinary pH and citrate sufficiently for stone prevention. Higher dosages are probably required for the prevention of magnesium loss and adverse symptoms of thiazide therapy.

Topics: Adult; Benzothiadiazines; Citrates; Citric Acid; Diuretics; Dose-Response Relationship, Drug; Drug Combinations; Female; Humans; Hydrogen-Ion Concentration; Hypokalemia; Kidney Calculi; Magnesium; Magnesium Compounds; Magnesium Deficiency; Male; Potassium; Potassium Compounds; Random Allocation; Recurrence; Sodium Chloride Symporter Inhibitors; Time Factors

To ascertain whether hypomagnesemia develops during short-term thiazide treatment in normal subjects and if it can be corrected by potassium-magnesium citrate (Relyte) supplementation.. Serum magnesium data were retrieved from 242 normal subjects from prior 4 trials. After 1-3 weeks of treatment with hydrochlorothiazide 50 mg/day, subjects received supplementation with Relyte or a related compound while continuing on thiazide for 3 weeks.. Hypomagnesemia (< or =1.8 mg/dl) was disclosed in 19.4% of 242 subjects on thiazide alone. In such patients, Relyte treatment significantly increased serum magnesium concentration to the normal range, whereas supplementation with potassium citrate or potassium chloride did not. In the Relyte group comprised of 131 subjects, the frequency of hypomagnesemia decreased from 22.9% on thiazide alone to 4.6% after 4 weeks of Relyte supplementation. In contrast, the frequency of hypomagnesemia displayed a non-significant increase from 15.7% on thiazide alone to 20-24% on potassium citrate or potassium chloride.. Mild hypomagnesemia develops in about one fifth of normal subjects during short-term thiazide treatment. Relyte can readily correct it.

Topics: Benzothiadiazines; Citrates; Diuretics; Drug Combinations; Humans; Magnesium; Magnesium Compounds; Magnesium Deficiency; Potassium Compounds; Randomized Controlled Trials as Topic; Sodium Chloride Symporter Inhibitors