Abstract: SA-PO534
Correlation between Ionized and Total Magnesium in Children on Continuous Kidney Replacement Therapy
Session Information
- Acid-Base, Calcium, Potassium, and Magnesium Disorders: Clinical
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Mohan, Shruthi, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Hasson, Denise Claire, NYU Langone Health Hassenfeld Children's Hospital, New York, New York, United States
- Rose, James, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Benoit, Stefanie W., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
Background
Abnormal magnesium (Mg) levels are associated with poor outcomes in critically ill children. Regional citrate anticoagulation (RCA) during continuous renal replacement therapy (CRRT) may deplete Mg by chelating ionized Mg (iMg) and lead to negative Mg balance. iMg data in children on CRRT are sparse, and existing concordance data between iMg and total Mg (tMg) levels are conflicting. We assessed iMg/tMg correlation in critically ill children during CRRT with RCA.
Methods
Blood samples collected prospectively to measure iMg immediately before, 1-2, and 18-24 hours after the first CRRT start. We compared iMg to tMg levels obtained for clinical purposes. Normal iMg and tMg were based on reference ranges of 0.44-0.65 and 0.66-1.07 mmol/L, respectively.
Results
17 patients provided 48 iMg and 37 tMg samples. Low iMg was seen in 12% (2/17) at CRRT start, 35% (6/17) at 1-2 and 70% (12/17) at 18-24 hours. iMg decreased over time (β = - 0.005, p < 0.001). iMg and tMg levels showed moderate correlation (r = 0.71, p <0.0001). The citrate dose, CRRT effluent dose, CRRT fluid type, or Mg dose in parenteral nutrition did not differ between patients with normal vs. low iMg at 24 hours after CRRT initiation.
Conclusion
iMg and tMg showed moderate correlation in critically ill children receiving CRRT with RCA. Increased prevalence of low iMg within 24 hours of CRRT initiation highlights the need for vigilant Mg monitoring and further exploration of Mg trends after 24 hours.
Funding
- Commercial Support – Nova Biomedical provided critical care blood gas analyzer and supplies for research