Muscle cramps (involuntary muscle contraction associated with severe pain) occur frequently in patients receiving dialysis. Muscle cramps can involve the legs, most commonly in the feet, but can also involve arms and hands, as well as abdominal muscles. It is estimated that 33% to 86% of patients receiving dialysis have experienced cramps. In a study from 2001, 25% of hemodialysis patients reported two or more cramps weekly.
Muscle cramps begin with muscle twitches, and can be very painful in any circumstances. As you are likely recall, cramps can be so painful you can hardly move. Unfortunately, this can occur during hemodialysis treatment. It is not unusual for the cramp to lead to the dialysis session being terminated earlier than planned, leading to a less effective dialysis for that treatment, something that should be avoided for long-term health.
There are numerous factors that directly contribute to muscle cramps in Chronic Kidney Disease (CKD) patients receiving dialysis including a decrease in body fluid volume, abnormally low blood pressure (hypotension), changes in electrolyte-water balance, low levels of sodium, inadequate oxygen, low magnesium in blood, carnitine (an amino acid) deficiency, and elevated serum leptin (a hormone that regulates appetite and energy). Patients who experience cramps associated with dialysis have been reported to have lower parathyroid hormone levels than patients who do not experience cramps. Low concentrations of sodium in the dialysate bath, and increased ultrafiltration required to remove excess fluid are factors related to the dialysis procedure itself, which increase the risk of muscle cramps.
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