Why do you get cramps while on dialysis?

The article is professionally consulted by Master, Doctor Le Thi Minh Huong - Doctor of Resuscitation - Emergency, Department of Resuscitation - Emergency, Vinmec Nha Trang International General Hospital

Cramps are one of the common complications in hemodialysis patients, usually in the lower extremities. It may be because the muscles react to the fluid loss that occurs during hemodialysis.

A cramp is a strong, painful contraction and tightening of the muscles that usually comes on suddenly and lasts from a few seconds to a few minutes. Cramps can occur in the lower extremities, thighs, or feet, and often occur while awake or asleep.
There are many causes leading to symptoms of cramps such as: Excessive exercise; lack of calcium, potassium, magnesium; due to aging of the nervous, muscular and vascular systems; electrolyte imbalance; stress, anxiety,... Especially in hemodialysis patients, it affects the patient's sleep and life.

The cause of cramps during hemodialysis is still unknown. However, predisposing factors for cramping include:
Low blood pressure; Volume reduction: Weight less than dry weight; High ultrafiltration rate: A lot of weight gain between two dialysis sessions; The filtrate has a low sodium concentration. These factors cause vasoconstriction, decreased muscle perfusion, disordered muscle relaxation and lead to cramps. Cramps occur in association with hypotension and are often persistent, even though blood pressure has recovered. In addition, hypomagnesemia and hypocalcemia are also considered potential causes of treatment-resistant cramps. Hypokalemia prior to hemodialysis will aggravate this condition because the usual dialysis potassium levels can also cause cramps. In addition, cramping is more common in the first month of dialysis than later in life.

In order to prevent cramps from occurring during hemodialysis, risk factors should first be addressed, such as prevention of hypotension by infusion of 0.9% NaCl. Adjust weight loss and salt intake during dialysis and between hemodialysis sessions. In addition, patients need to practice stretching exercises for muscle cramps, regular massage of limbs and proper nutrition.
In summary, cramps are one of the complications of hemodialysis. It is currently unknown what causes cramps. However, risk factors such as low blood pressure, electrolyte imbalance, excessive weight gain between two dialysis sessions, etc. can cause cramps. To effectively prevent cramps, patients can massage and do exercises for muscle group cramps as well as combine with a reasonable diet.
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