Risk factors of hypermagnesemia in end-stage cancer patients hospitalized in a palliative care unit

Despite the fact that hypermagnesemia is a relatively common electrolyte abnormality among end-stage cancer patients, a clinical approach to avoiding hypermagnesemia in these patients has yet to be identified. Thus, we designed a cross-sectional study to identify a clinical approach to avoiding hypermagnesemia in end-stage cancer patients receiving palliative care and considered whether these risk factors could be avoided in end-stage cancer patients. Patients with end-stage cancer who were hospitalized in a palliative care unit at Himeji St. Mary's Hospital, Japan, between January 2017 and December 2019 were included in the study. Laboratory results of the blood samples collected from the subjects were examined. Participants' medical records were assessed to identify previously reported risk factors of hypermagnesemia and evaluate the physical status specific to end-stage cancer patients. Logistic regression analysis was used to analyze the relationship between risk factors and physical status. During the study period, 674 end-stage cancer patients were hospitalized in the subject palliative care unit. Serum magnesium levels were measured in 533 patients, and hypermagnesemia was observed in 123 (23.08%) of them. Renal dysfunction, short prognosis prediction, and oral magnesium oxide laxative were all significant predictor variables of a higher rate of hypermagnesemia. Patients who had all three risk factors had a significantly higher incidence of hypermagnesemia. Thus, it is important not to use magnesium oxide laxatives on end-stage cancer patients to prevent hypermagnesemia-especially when renal dysfunction is observed and a short prognosis is predicted.