Assessing the cause of abnormal serum magnesium concentrations
Determining whether nutritional magnesium loads are adequate
Calculating urinary calcium oxalate and calcium phosphate supersaturation and assessing kidney stone risk.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
MCTR1 | Magnesium/Creat Ratio, Random, U | No | Yes |
MGCO | Magnesium, Random, U | No | Yes |
CRETR | Creatinine, Random, U | No | Yes |
MGCO: Colorimetric Endpoint Assay
CRETR: Enzymatic Colorimetric Assay
MCTR1: Calculation
Magnesium, Random, U
Urine
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 5-mL tube or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 4 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative.
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
1 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 14 days | |
Frozen | 30 days | ||
Ambient | 72 hours |
Assessing the cause of abnormal serum magnesium concentrations
Determining whether nutritional magnesium loads are adequate
Calculating urinary calcium oxalate and calcium phosphate supersaturation and assessing kidney stone risk.
Magnesium, along with potassium, is a major intracellular cation. Magnesium is a cofactor of many enzyme systems. All adenosine triphosphate-dependent enzymatic reactions require magnesium as a cofactor. Approximately 70% of magnesium ions are stored in bone. The remainder are involved in intermediary metabolic processes; about 70% are present in free form, while the other 30% are bound to proteins (especially albumin), citrates, phosphate, and other complex formers. The serum magnesium level is kept constant within very narrow limits.
Renal handling of magnesium is determined by the combination of filtration and reabsorption. Roughly 70% of the magnesium in plasma is filtered by the glomeruli; 20% to 30% of the filtered magnesium is reabsorbed in the proximal tubule, while less than 5% is reabsorbed in the distal tubule and collecting duct.(1)
Numerous causes of renal magnesium wasting have been identified including (but not limited to) congenital defects (including Barter and Gitelman syndrome), various endocrine disorders (including hyperaldosteronism and hyperparathyroidism), exposure to certain drugs (ie, diuretics, cis-platinum, aminoglycoside antibiotics, calcineurin inhibitors), and other miscellaneous causes (including chronic alcohol abuse). Gastrointestinal conditions associated with fat malabsorption and chronic diarrhea can cause fecal magnesium loss and hypomagnesemia.
High levels of plasma magnesium are typically only seen in patients with decreased renal function, after administration of a magnesium load large enough to exceed the kidneys' ability to excrete it, or a combination of the two.(2)
Magnesium is an inhibitor of calcium crystal growth and contributes to urinary calcium oxalate and calcium phosphate supersaturation. However, low urinary magnesium in isolation has not been identified as a common cause of kidney stones, nor has magnesium supplementation been proven as an effective therapy for stone prevention.
1 month-<12 months: 0.10-0.48 mg/mg creat
12 months-<24 months: 0.09-0.37 mg/mg creat
24 months-<3 years: 0.07-0.34 mg/mg creat
3 years-<5 years: 0.07-0.29 mg/mg creat
5 years-<7 years: 0.06-0.21 mg/mg creat
7 years-<10 years: 0.05-0.18 mg/mg creat
10 years-<14 years: 0.05-0.15 mg/mg creat
14 years-<18 years: 0.05-0.13 mg/mg creat
18 years-83 years: 0.04-0.12 mg/mg creat
Reference values have not been established for patients who are younger than 1 month.
Reference values have not been established for patients who are older than 83 years.
Urinary magnesium excretion should be interpreted in concert with serum concentrations.
In the presence of hypomagnesemia, a 24-hour urine magnesium above 24 mg/day or fractional excretion above 0.5% suggests renal magnesium wasting. Lower values suggest inadequate magnesium intake and/or gastrointestinal losses.
In the presence of hypermagnesemia, urinary magnesium levels provide an indication of current magnesium intake.
Lower urinary magnesium excretion increases urinary calcium oxalate and calcium phosphate supersaturation and could contribute to kidney stone risk.
Urinary magnesium excretion must be interpreted with caution during periods of intravenous magnesium infusion.
1. Delaney MP, Lamb EJ. Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1309
2. Al Ghamdi SM. Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis. 1994;24(5):737-752
3. Sutton RA. Abnormal renal magnesium handling. Miner Electrolyte Metab. 1993;19(4-5):232-240
Magnesium:
In alkaline solution, magnesium forms a purple complex with xylidyl blue, diazonium salt. The magnesium concentration is measured photometrically via the decrease in xylidyl blue absorbance.(Package insert: Roche MG2 kit. Roche Diagnostics; V17.0 03/2022)
Creatinine:
The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus ver 2. Roche Diagnostics; V2.0 03/2023)
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
83735
82570
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
MAGRU | Magnesium/Creat Ratio, Random, U | 13474-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
CRETR | Creatinine, Random, U | 2161-8 |
MGCO | Magnesium, Random, U | 19124-7 |
MCTR1 | Magnesium/Creat Ratio, Random, U | 13474-2 |