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Hypomagnesemia in Diuretic-Treated Patients-Reply

Kurt Kroenke, MC, USA; David R. Wood, MC, USA
Arch Intern Med. 1988;148(2):481. doi:10.1001/archinte.1988.00380020225031.
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In Reply.  —Drs Sadjadi and Shah fail to refute our conclusion. Indeed, they highlight, as we did, the shortcomings of serum magnesium determinations. They argue that the percentage of magnesium retention following a test load is a better indicator of body magnesium stores than in serum magnesium. They state that "all one has to do is to stop the diuretic for three to four days, and then measure the retained percentage of magnesium load in the next 24 hours." However, for the millions of diuretic-treated patients in this country, this would not be a test one would routinely obtain. Finally, the number of patients for whom Drs Sadjadi and Shah determined the percentage retention of magnesium load is much too small for us to draw either statistically or clinically significant conclusions.Drs Sadjadi and Shah contradict themselves when they say that "hypomagnesemia is much more common than determination of serum


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