Magnesium homeostasis and renal magnesium handling.

Magnesium is essentially an intracellular cation, which makes it difficult to evaluate magnesium status. About 1% of total body magnesium is present in serum and interstitial body fluid and only about 1% of the intracellular magnesium is in the free form, Mg2+. Recent studies show that this small fraction of free Mg2+ rapidly changes with the extracellular magnesium. These free Mg2+ levels are carefully controlled within the cell and total cellular magnesium content are maintained at the expense of extracellular fluid and bone magnesium levels. Regulation of magnesium balance is met between intestinal absorption and renal excretion. The excretory side of magnesium balance involves appropriate changes in renal magnesium handling. Present evidence indicates that renal handling of magnesium normally is a filtration-reabsorption process; magnesium is filtered at the glomerulus and reabsorbed along the various segments making up the renal nephron. About 80% of total serum magnesium (0.7-1 mmol/l) is filtered at the glomerular membrane. Of the ultrafilterable magnesium (0.6-0.8 mmol/l) 20-25% is reabsorbed by the proximal tubule, including the convoluted and straight portions. Some 50-60% of the filtered magnesium is reabsorbed in the loop of Henle, specifically by thick ascending limb cells. The terminal nephron segments, including the distal convoluted tubule and collecting ducts, reabsorb only a small portion of the filtered magnesium (about 5-10%). The loop of Henle plays the major role in determining magnesium reabsorption and urinary magnesium excretion. The loop of Henle also is the segment in which the major regulatory factors act to maintain magnesium balance.(ABSTRACT TRUNCATED AT 250 WORDS)