Hypermagnesaemia in presence of magnesium depletion in acute-on-chronic renal failure.

A patient with renal failure developed hypermagnesaemia, with confusion, drowsiness, and dysarthria. Nevertheless, the dietary magnesium content was low, and investigation showed actual intracellular depletion of magnesium. The cause of this state is not known, though it is presumably connected with a failure to maintain the normal concentration gradient of magnesium across the cell wall. The clinical state and the serum magnesium level returned to normal after treatment with calcium gluconate.