Why does cisplatin cause hypomagnesemia?

Hypomagnesemia is a well known side-effect in patients receiving cisplatin-containing chemotherapy. Cisplatin induces hypomagnesemia through its renal toxicity possibly by a direct injury to mechanisms of magnesium reabsorption in the ascending limb of the loop of Henle as well as the distal tubule.

Does Chemo deplete magnesium?

Highlights. Platinum chemotherapy drugs including Cisplatin and Carboplatin, although effective cancer drugs, are also known to cause severe side-effects, one of them being a drastic depletion in the levels of the essential mineral Magnesium in the body, that leads to kidney injury.

How does cisplatin cause electrolyte imbalance?

Direct injury to magnesium reabsorption in the ascending limb of loop of Henle, as well as the distal tubule, is the possible mechanisms by which cisplatin specifically induces hypomagnesemia [18] (Fig. 2).

How do you fix hypomagnesemia?

Treat with magnesium salts when magnesium deficiency is symptomatic or persistently < 1.25 mg/dL (< 0.50 mmol/L). Give oral magnesium salts unless patients have seizures or other severe symptoms, in which case, give 2 to 4 g of magnesium sulfate IV over 5 to 10 minutes.

Why is magnesium low after chemo?

This review summarizes magnesium physiology and highlights the mechanisms underlying magnesium disturbances due to cancer and cancer treatment. The causes of hypomagnesemia can be categorized according to the pathophysiologic mechanism: decreased intake, transcellular shift, gastrointestinal losses, and kidney losses.

Why does chemo lower magnesium?

Platinum-Based Chemotherapy Cisplatin causes direct injury to tubular cells in the TAL and DCT and is the likely mechanism by which cisplatin induces hypomagnesemia. Also, cisplatin can lead to Mg loss from the gut because vomiting, diarrhea, and anorexia are common complications of platinum therapy.

What happens if magnesium levels are too low?

Over time, low magnesium can weaken your bones, give you bad headaches, make you feel nervous, and even hurt your heart. It can also lead to low levels of other important minerals like calcium and potassium.

How long do side effects of cisplatin chemotherapy last?

Nausea and vomiting usually begin within 1 to 4 hours after treatment and last up to 24 hours. Various degrees of vomiting, nausea and/or anorexia may persist for up to 1 week after treatment.

How long does it take to correct hypomagnesemia?

In less severe cases of hypomagnesemia, gradual repletion may be achieved by administration of smaller parenteral doses over 3 to 5 days until the serum magnesium concentration is normal.

Why is my body low on magnesium?

Low magnesium is typically due to decreased absorption of magnesium in the gut or increased excretion of magnesium in the urine. Low magnesium levels in otherwise healthy people are uncommon. This is because magnesium levels are largely controlled by the kidneys.

How is cisplatin related to renal magnesium wasting?

DISCUSSION. The direct damage of cisplatin to these tubular cells causes urinary Mg wasting and occurs in approximately half of patients treated with cisplatin-containing regimens, although the cellular alterations of cisplatin leading to renal magnesium wasting are not well understood.

How is hypomagnesemia a side effect of cisplatin?

Cisplatin induces hypomagnesemia through its renal toxicity possibly by a direct injury to mechanisms of magnesium reabsorption in the ascending limb of the loop of Henle as well as the distal tubule. … Hypomagnesemia is a well known side-effect in patients receiving cisplatin-containing chemotherapy.

Is it safe to take magnesium before cisplatin?

The cisplatin template of the national comprehensive cancer network (NCCN) recommended hyper diuresis using magnesium supplementation (8 mEq) before the administration of cisplatin.

How long should cisplatin be in solution with mannitol?

Some references recommend that cisplatin be infused over several hours in solution with mannitol, 2 however this duration of cisplatin infusion is not appropriate for many chemotherapy regimens.