Abstract: Magnesium was detected in the human plasma of individuals (n = 20) with various kidney diseases and having gonorrhea. The values were relatively higher than those of controls (n = 20) (individuals without kidney diseases and without infection with Neisseria gonorrhea or any other veneral disease). Two of the individuals within the control group had plasma magnesium concentrations below 0.9 mg per 100 mL. The other eighteen individuals had values within the range of 0.9-1.9 mg per 100 mL. None of the infected patients with kidney disease had plasma magnesium concentration below 0.9 mg per 100 mL. All infected females with kidney diseases had plasma magnesium concentration above 1.9 mg per 100 mL. Of the total infected males, with various kidney diseases, 35% had plasma magnesium concentrations above 1.9 mg per 100 mL. Inspite of the fact that gonococal infection affects the upper renal tract, there seems to be no significant effect of such infection on plasma hypermagnesemia in individuals with certain kidney diseases. Hypermagnesemia could therefore still be a problem in patients with gonococal infection accompanied with renal diseases.
INTRODUCTION
Gonorrhea, a veneral disease caused by Neisseria gonorrhea causes inflammation of both male and female genitalia. The gonococcus can attack intact epithelia, does not penetrate deeply into the tissues and ascends by surface continuity. The disease exists either in an acute or chronic form and affects the urinary bladder and upper renal tract[1]. Frequent and burning micturition is an important symptom of gonorrhea in adults[2].
Magnesium ion (Mg2+) has an ionic radius half that of Potassium ion (K+), is present in biological fluids and acts as catalyst in the phosphorylation of Glucose[3,4]. It plays a role in the release of acetylcholine, enzyme activation, ribonucleic and deoxyribonucleic reaction, amino acid activation and protein synthesis[5]. It is normally absorbed into the body from the GUT after diet. The kidney seems to be an important organ in its excretion[6].
Chronic infection with Neisseria gonorrhea affects the upper renal tract and urinary bladder. Hypermagnesemia in plasma has been observed as an important problem in renal failure[7]. This study was designed to determine magnesium levels in individuals having renal diseases with chronic Neisseria gonorrhea infection
.
MATERIALS AND METHODS
Subjects: The test subjects consist of twenty individuals with various kidney diseases diagnosed medically as having gonorrhea at the Special Treatment Clinic of the department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria. Symptoms observed in the subjects ranged from burning micturition to mucopurulent discharges from the urinogenitals. The control group consisted of twenty individuals with no history of gonococcal infection or any other veneral disease and without any form of kidney disease.
Blood Sample Collection: About 5 mL of venous blood samples were collected using syringes, from the arms of the subjects, into heparinized blood containers. Plasma was separated after centrifugation at 3,000 rpm for 10 min. Blood collection was done between 10 am and 11 am for uniformity of samples. Plasma samples were stored at -20°C until they were analysed for magnesium.
Magnesium content analysis: Magnesium content of plasma samples were analysed using the atomic absorption spectrophotometry method[8].
RESULTS
The magnesium concentration in normal human plasma should be of the range 0.9-1.9 mg per 100 mL (Table 1).
| Table 1: | WHO Reference value ranges in the normal human plasma. (University College Hospital, Ibadan. Nigeria) |
| Table 2: | Plasma Magnesium concentration in normal controls (Individuals without kidney disease and without Neisseria gonorrhea infection) |
| Key: M = Male; F = Female | |
Two of the patients (without kidney diseases and without Neisseria gonorrhea infection) within the normal control group had plasma magnesium concentrations below 0.9 mg per 100 mL. The values were 0.80 mg per 100 mL and 0.75 mg per 100 mL respectively. The other eighteen individuals had plasma magnesium concentrations within the range of 0.9-1.9 mg per 100 mL (Table 2).
None of the infected patients with kidney disease had plasma magnesium concentration below 0.9 mg per 100 mL. All the infected females with kidney diseases had plasma magnesium concentrations above 1.9 mg per 100 mL. Of the total infected males, with various kidney diseases, 35% had plasma magnesium concentrations above 1.9 mg per 100 mL (Table 3).
The only infected patient with renal failure had plasma magnesium concentration above 1.9 mg per 100 mL. Seventy one percent of infected patients with Nephrotic syndrome had plasma magnesium concentrations above 1.9 mL per 100 mL. Seventy five percent of infected patients with chronic nephrosis had plasma magnesium concentration above 1.9 mg per 100 mL. Fifty percent of infected patients with nephrosis had plasma magnesium concentrations above 1.9 mg per 100 mL (that is, the only female patient with nephrosis had plasma magnesium concentration above 1.9 mg per 100 mL).
| Table 3: | Plasma magnesium concentrations in patients with various kidney diseases, infected with Neisseria gonorrhea |
| Key: M = Male; F = Female. | |
Both infected females with renal failure had plasma magnesium concentrations above 1.9 mg per 100 mL (Table 3).
DISCUSSION
Magnesium was detected in the human plasma of individuals with various kidney diseases, infected with Neisseria gonorrhea and in that of the controls (individuals without kidney diseases and without infection with Neisseria gonorrhea). According to Rose[7], magnesium constitutes 0.73% (meq L-1) of total plasma cation. Most of the magnesium, of the body is in the cells, where the concentration is about twenty times as great as in the plasma[9]. Two individuals within the normal control group had plasma magnesium concentration below the value range of that of the normal human plasma. Magnesium is largely intracellular, magnesium depletion accompanies loss of cell potassium and is occasionally seen due to prolonged postoperative secretion loss[9]. Hypomagnesemia of any cause can lead to K+ depletion and hpokalemia. Increased urinary excretion is the primary source of K+ loss[7]. The enhancement of neuromuscular irritability that gives rise to tetany is sometimes caused by low plasma magnesium ion concentration[9]. However, raised plasma magnesium levels are consistently found in chronic nephritis with renal failure[9].
Magnesium and calcium play a role in the release of acetylcholine, enzyme activation, ribonucleic and deoxyribonucleic reaction, amino acid activation and protein synthesis. The mean value of plasma magnesium is approximately 1.5 mg dL-1[8,10]. Hyperglycemia in plasma have been observed in patients with acute and chronic renal failure[11].
Gonorrhea affects the urinary bladder and upper renal tract[1]. Frequent and burning micturition is an important symptom of gonorrhea in adults[2]. Though the kidney plays an important role in the maintenance of serum magnesium within the normal range[12], an average of 162 mg of magnesium can be detected in the urine of a man with unregulated diet within a 24 h period.
Inspite of the fact that Gonococcal infection affects the upper renal tract, there seems to be no significant effect of such infection on plasma hypermagnesemia in individuals with certain kidney diseases. Hypermagnesemia in plasma could therefore still be an important problem in patients with renal diseases accompanied with gonococal infection.