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Hidenori Matsuo, MD, Hidaka Hospital, 886 Nakao machi, Takasaki, Gunma 370 (Japan) Dear Sir, It is understood that hypermagnesemia can occur in patients with chronic renal failure during the administration of magnesium even at a pharmacological dose. According to previous reports about hypermagnesemia, which the authors could refer to, the serum calcium level of those patients was decreased or unchanged [1,2]. We report our experience with a case of hypermagnesemia accompanied by hypercalcemia induced by a magnesium laxative, which occurred in a hemodialysis patient. A 63-year-old male was transferred to the Kita Hospital from a dialysis clinic because of neurological changes. He suffered from chronic renal failure and anuria due to chronic glomerulonephritis, having received hemodialysis for 7 years. The patients had had occasional episodes of obstipation. 6 weeks previously, he had complained of a sense of fullness, loss of appetite, and no passage for 10 days. Magnesium oxide powder was administered at 3.0 g/day, since different purgatives tried up to then had failed to improve his complaint. A few days later, he had a passage every day, and his appetite improved. In the 4th week, however, he began to manifest vomiting, became irritable, confused, and disoriented regarding time and surroundings. On admission, he was of medium stature for a Japanese male: 160 cm in height, weighing 54 kg. His state of consciousness was stuporous. However, deep tendon reflexes were present and the respiratory movement was not impaired. Blood pressure was 216/104 mm Hg. Pulse rate was 80, regular and full. The ECG showed a regular sinus rhythm. The blood chemistry revealed a marked elevation of serum magnesium up to 9.9 mg/dl. This was on the 35th day, since magnesium administration was begun. We decided to start dialyzing every day. His state of consciousness improved on the 4th day. Intermittent hemodialysis was performed every day until the 23rd hospital day, when the serum magnesium level returned to normal.