Kidney Week

Abstract: SA-PO0094

Severe Acute Hypermagnesemia After Inadvertent Bath Agent Ingestion

Session Information

• Artificial Intelligence: Kidney Imaging, Pathology, and Precision Phenotyping
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Artificial Intelligence, Digital Health, and Data Science

• 300 Artificial Intelligence, Digital Health, and Data Science

Authors

• Chen, Chien-Chou, Tri-Service General Hospital Songshan Branch, Taipei City, Taiwan

Chien-Chou Chen, MD

• Yang, Tzu Hsien, Tri-Service General Hospital, Taipei City, Taiwan

Tzu Hsien Yang, MD

• Lin, Shih-Hua, Tri-Service General Hospital, Taipei City, Taiwan

Shih-Hua Lin, MD

Introduction

Severe acute hypermagnesemia is a rare but potentially fatal electrolyte emergency, typically resulting from exogenous magnesium administration, requiring prompt recognition and management.

Case Description

A 54-year-old man presented with drowsy consciousness after inadvertently ingesting 100ml of concentrated bath agent containing 30% MgCl, 33% MgSO4, and 10% K₂SO₄ (estimated Mg 18g). On arrival, he had GCS E3V2M5, facial flushing, bilateral limb weakness, and diminished deep tendon reflexes. Laboratory tests showed severe hypermagnesemia (Mg 15.8 mg/dL). Arterial blood gas revealed mixed metabolic and respiratory acidosis with pH 7.18, PCO₂ 50 mmHg, HCO₃^- 18.4 mmol/L. Admission AI-ECG identified a PR99 mortality risk, suggesting impending cardiovascular collapse despite a non-specific rhythm (Figure 1A).
Due to the severity of the patient's neurological and cardiovascular compromise, intravenous volume expansion, calcium, and diuretics , emergent hemodialysis were initiated. The intervention led to rapid and efficient clearance of serum magnesium, reducing levels to 5.0 mg/dL within 4 hours. Concurrently, the patient experienced a dramatic clinical improvement; his consciousness was almost completely clear within 6 hours after hemodialysis , and his AI-ECG mortality risk score decreased from 99 to 83 (Figure 1B).

Discussion

AI-ECG risk stratification identified a high mortality risk before overt malignant arrhythmias, and its subsequent decline paralleled neurological and biochemical recovery, suggesting its potential role as a useful adjunct for tracking magnesium-induced cardiotoxicity alongside conventional biochemical monitoring.

Figure 1A: AI-ECG for prediction of mortality risk in the setting of acute hypermagnesemia
Figure 1B: Sequential AI-ECG prediction of mortality risk