Which combination can cause hypermagnesemia?

Which combination can cause hypermagnesemia?

• A. Renal failure with antacid ingestion
• B. Renal failure alone
• C. Liver failure with alcohol
• D. Dehydration with diuretics

Answer: (A)

Magnesium balance hinges on kidney excretion. When kidney function is impaired, the body can’t clear magnesium effectively, so levels rise. Adding a large magnesium load, such as magnesium-containing antacids, pushes serum magnesium up further. So the combination of renal failure plus ingestion of magnesium-containing antacids provides both a high intake and reduced clearance, making hypermagnesemia likely. In other scenarios, the risk isn’t as strong: renal failure alone can raise magnesium but usually not dramatically without an additional magnesium source; liver failure with alcohol doesn’t inherently add a significant magnesium load; dehydration with diuretics tends to promote magnesium loss rather than retention.

Magnesium balance hinges on kidney excretion. When kidney function is impaired, the body can’t clear magnesium effectively, so levels rise. Adding a large magnesium load, such as magnesium-containing antacids, pushes serum magnesium up further. So the combination of renal failure plus ingestion of magnesium-containing antacids provides both a high intake and reduced clearance, making hypermagnesemia likely.

In other scenarios, the risk isn’t as strong: renal failure alone can raise magnesium but usually not dramatically without an additional magnesium source; liver failure with alcohol doesn’t inherently add a significant magnesium load; dehydration with diuretics tends to promote magnesium loss rather than retention.