Prevention of thiazide-induced hypokalemia without magnesium depletion by potassium-magnesium-citrate

American Journal of Therapeutics
Clarita V OdvinaCharles Y C Pak

Abstract

Thiazide can cause magnesium depletion, which may exaggerate renal potassium wasting and hypokalemia. The purpose of this double-blind, randomized trial was to compare the metabolic effects of potassium-magnesium-citrate (K-Mg-citrate) and potassium chloride (KCl) during long-term treatment with thiazide. Twenty-two normal volunteers received hydrochlorothiazide 50 mg/d. Ten subjects concurrently took K-Mg-citrate (42 mEq K/d and 21 mEq Mg/d), and 12 subjects were given KCl 42 mEq/d. Serum potassium concentration remained unchanged during K-Mg-citrate supplementation, with a change from baseline of 21.7% over 6 months, compared with 26.4% with KCl supplementation. Serum electrolytes were normal and not significantly different between K-Mg-citrate and KCl. During K-Mg-citrate treatment, serum magnesium increased significantly by about 10%, associated with an adequate increase in urinary magnesium and a nonsignificant increase in monocyte and free muscle magnesium. Serum magnesium was unchanged, and monocyte and free muscle magnesium showed a nonsignificant decline during KCl supplementation. K-Mg-citrate provided an alkali load, increasing urinary pH, and reducing urinary undissociated uric acid. It also increased urinary citrat...Continue Reading

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Citations

Aug 15, 2009·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Bevin A ClareKevin Spelman
Jul 22, 2011·Kidney International·Charles Y C PakPaul C Peters
Dec 19, 2006·The Journal of Evidence-based Dental Practice·Anwar T Merchant
Feb 18, 2012·The Cochrane Database of Systematic Reviews·Andrew S Worster, Wendy Bhanich Supapol

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