What is the prevalence of hypermanganesemia in home PN patients?

• A. Hypermagnesemia has been reported in >50% of home PN patients
• B. Hypermagnesemia has been reported in <10% of home PN patients
• C. Hypermagnesemia has not been observed in home PN
• D. Hypermagnesemia is always symptomatic

Answer: (A)

Magnesium balance in long‑term home PN is a common concern because magnesium is included in PN solutions and clearance depends on kidney function. When patients have reduced renal excretion or receive a relatively high magnesium load, serum magnesium can rise. Across several home PN cohorts, hypermagnesemia has been documented in a large portion of patients, with reports often exceeding 50%. This makes the statement that hypermagnesemia has been reported in more than half of home PN patients the best fit.

It’s not accurate to say it’s rare, never seen, or always symptomatic. Some patients remain asymptomatic with mild elevations, while others may develop symptoms only at higher levels, which is why monitoring and adjusting magnesium dosing are important.