Limits...
Severe intracellular magnesium and potassium depletion in patients after treatment with cisplatin.

Lajer H, Bundgaard H, Secher NH, Hansen HH, Kjeldsen K, Daugaard G - Br. J. Cancer (2003)

Bottom Line: Thus, P-Mg and P-K are not reliable indicators for Mg and K depletion during treatment with cisplatin.However, the majority of patients will present Mg and K depletion after cisplatin therapy and of these only very few patients will present a low P-Mg or P-K.Therefore, routine supplementation should be considered in all patients receiving cisplatin.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology 5072, Rigshospitalet, University of Copenhagen, The Finsen Center, Blegdamsvej 9, Copenhagen DK-2100, Denmark. H.LAJER@rh.dk

ABSTRACT
The purpose of this study is (1) to evaluate skeletal muscle magnesium (Mg) and potassium (K) during treatment with cisplatin; (2) to evaluate the predictive value of plasma (P)-Mg for intracellular Mg during cisplatin treatment; and (3) to evaluate whether changes in intracellular K influence skeletal muscle Na,K-ATPase. In all, 65 patients had a needle muscle biopsy obtained before and 26 patients both before and after cisplatin treatment. Biopsies were analysed for Mg, K, and Na,K-ATPase concentrations, and P-Mg and P-K determined. Treatment with a total dose of approximately 500 mg (270 mg m(-2) surface area) cisplatin over 80 days was associated with reductions in muscle [Mg] (95% CI) (8.95 (8.23-9.63) to 7.76 (7.34-8.18) mumol g(-1) wet wt. (P<0.01), and muscle [K] (90.81 (83.29-98.34) to 82.87 (78.74-87.00) mumol g(-1) wet wt. (P<0.05), as well as in P-Mg 0.82 (0.80-0.85) to 0.68 (0.64-0.73) mmol l(-1) (P<0.01 but not in P-K (4.0 (3.8-4.1) vs 3.8 (3.7-4.0) mmol l(-1)). No simple correlations were observed between P-Mg and muscle [Mg], or between P-K and muscle [K], either before (n=65) or after (n=26) treatment with cisplatin. The changes in [Mg] and [K] were not associated with changes in the muscle Na,K-ATPase concentration. Following treatment with cisplatin, an approximately 15% decline in P-Mg was accompanied by an approximately 15% loss of muscle [Mg], as well as an approximately 10% reduction of muscle [K] and fatigue and muscle weakness previously ascribed to hypomagnesaemia may therefore also be well explained by muscle K depletion observed despite normal levels of P-K. There was no correlation between P-Mg and SM-Mg or between P-K and SM-K. Thus, P-Mg and P-K are not reliable indicators for Mg and K depletion during treatment with cisplatin. However, the majority of patients will present Mg and K depletion after cisplatin therapy and of these only very few patients will present a low P-Mg or P-K. Therefore, routine supplementation should be considered in all patients receiving cisplatin.

Show MeSH

Related in: MedlinePlus

P-Mg (A), SM-Mg (B), P-K (C) and SM-K (D) before and after treatment with cisplatin. Rings represent individual patients. Black ring represents mean and lines 95% confidence interval of mean.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2394419&req=5

fig1: P-Mg (A), SM-Mg (B), P-K (C) and SM-K (D) before and after treatment with cisplatin. Rings represent individual patients. Black ring represents mean and lines 95% confidence interval of mean.

Mentions: In the 26 patients with biopsies available before and after cisplatin treatment (Table 1), P-Mg fell from 0.82 (0.80–0.85) to 0.68 (0.64–0.73) mmol l−1 (P<0.01, mean difference 0.14 (0.09–0.19)); SM-Mg from 8.95 (8.23–9.63) to 7.76 (7.34–8.18) μmol g−1 wet wt. (P<0.01, mean difference 1.19 (0.39–1.98)) and SM-K from 90.81 (83.29–98.34) to 82.87 (78.74–87.00) μmol g−1 wet wt. (P<0.05, mean difference 7.94 (0.5–15.39), where as P-K did not change significantly (4.0 (3.8–4.1) to 3.8 (3.7–4.0) mmol l−1) (Figure 1Figure 1


Severe intracellular magnesium and potassium depletion in patients after treatment with cisplatin.

Lajer H, Bundgaard H, Secher NH, Hansen HH, Kjeldsen K, Daugaard G - Br. J. Cancer (2003)

P-Mg (A), SM-Mg (B), P-K (C) and SM-K (D) before and after treatment with cisplatin. Rings represent individual patients. Black ring represents mean and lines 95% confidence interval of mean.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2394419&req=5

fig1: P-Mg (A), SM-Mg (B), P-K (C) and SM-K (D) before and after treatment with cisplatin. Rings represent individual patients. Black ring represents mean and lines 95% confidence interval of mean.
Mentions: In the 26 patients with biopsies available before and after cisplatin treatment (Table 1), P-Mg fell from 0.82 (0.80–0.85) to 0.68 (0.64–0.73) mmol l−1 (P<0.01, mean difference 0.14 (0.09–0.19)); SM-Mg from 8.95 (8.23–9.63) to 7.76 (7.34–8.18) μmol g−1 wet wt. (P<0.01, mean difference 1.19 (0.39–1.98)) and SM-K from 90.81 (83.29–98.34) to 82.87 (78.74–87.00) μmol g−1 wet wt. (P<0.05, mean difference 7.94 (0.5–15.39), where as P-K did not change significantly (4.0 (3.8–4.1) to 3.8 (3.7–4.0) mmol l−1) (Figure 1Figure 1

Bottom Line: Thus, P-Mg and P-K are not reliable indicators for Mg and K depletion during treatment with cisplatin.However, the majority of patients will present Mg and K depletion after cisplatin therapy and of these only very few patients will present a low P-Mg or P-K.Therefore, routine supplementation should be considered in all patients receiving cisplatin.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology 5072, Rigshospitalet, University of Copenhagen, The Finsen Center, Blegdamsvej 9, Copenhagen DK-2100, Denmark. H.LAJER@rh.dk

ABSTRACT
The purpose of this study is (1) to evaluate skeletal muscle magnesium (Mg) and potassium (K) during treatment with cisplatin; (2) to evaluate the predictive value of plasma (P)-Mg for intracellular Mg during cisplatin treatment; and (3) to evaluate whether changes in intracellular K influence skeletal muscle Na,K-ATPase. In all, 65 patients had a needle muscle biopsy obtained before and 26 patients both before and after cisplatin treatment. Biopsies were analysed for Mg, K, and Na,K-ATPase concentrations, and P-Mg and P-K determined. Treatment with a total dose of approximately 500 mg (270 mg m(-2) surface area) cisplatin over 80 days was associated with reductions in muscle [Mg] (95% CI) (8.95 (8.23-9.63) to 7.76 (7.34-8.18) mumol g(-1) wet wt. (P<0.01), and muscle [K] (90.81 (83.29-98.34) to 82.87 (78.74-87.00) mumol g(-1) wet wt. (P<0.05), as well as in P-Mg 0.82 (0.80-0.85) to 0.68 (0.64-0.73) mmol l(-1) (P<0.01 but not in P-K (4.0 (3.8-4.1) vs 3.8 (3.7-4.0) mmol l(-1)). No simple correlations were observed between P-Mg and muscle [Mg], or between P-K and muscle [K], either before (n=65) or after (n=26) treatment with cisplatin. The changes in [Mg] and [K] were not associated with changes in the muscle Na,K-ATPase concentration. Following treatment with cisplatin, an approximately 15% decline in P-Mg was accompanied by an approximately 15% loss of muscle [Mg], as well as an approximately 10% reduction of muscle [K] and fatigue and muscle weakness previously ascribed to hypomagnesaemia may therefore also be well explained by muscle K depletion observed despite normal levels of P-K. There was no correlation between P-Mg and SM-Mg or between P-K and SM-K. Thus, P-Mg and P-K are not reliable indicators for Mg and K depletion during treatment with cisplatin. However, the majority of patients will present Mg and K depletion after cisplatin therapy and of these only very few patients will present a low P-Mg or P-K. Therefore, routine supplementation should be considered in all patients receiving cisplatin.

Show MeSH
Related in: MedlinePlus