Study on Muscle Cramps in End-Stage Renal Disease Patients on Hemodialysis and Analysis of Factors Contributing to Muscle Cramps including Magnesium

Abstract

Background: One of the most prevalent and potentially fatal illnesses affecting people worldwide is chronic kidney disease. This is characterized as one of the causes of illness and death of this century. Additionally, this has an impact on the patient's daily activities, such as their social life, freedom to work, and physical activity. Consequently, this is among the causes of cardiovascular disease and death.

Material and methods: This cross-sectional observational study conducted for 6 months from November 2023 to March 2024 in the nephrology department among 76 patients and blood samples were collected during muscle cramps in hemodialysis for Sodium, Potassium, Calcium, and Magnesium to assess an electrolyte change. A visual analog scale assessed the severity of muscle cramps at the time of muscle cramps. Self-made questionnaire was asked to patients regarding the incidence, frequency, management, severity, location, and time of muscle cramps. Patient's interdialytic weight gain, pre-dialysis blood pressure, post-dialysis blood pressure, and blood pressure during muscle cramps were recorded.

Results: The mean age of the patients in this study was 55.57. Hypertension (54.6%) is the major comorbidity and diabetic mellitus (37.3%) are the second most common comorbidity. The mean dry weight of the patients is 58.46 Kg in this study with a mean inter-dialytic weight gain is 3.65±1.20. 58 (77%) people majorly were on thrice-weekly dialysis, 16 (21%) people were on twice-weekly dialysis, and 1 (1%) patient was on once-weekly dialysis. 55 (73.3%) had muscle cramps at the end of the dialysis and 20 (26.7%) had muscle cramps at mid-session of dialysis. 33(44%) patients had a visual analog scale score of 2, 30 (40%) patients had 3, 7 (9.3%) patients had 4, and 5 (6.6%) patients had 1 respectively. and no patients had a 5 visual analog scale score.

Conclusion: The frequency of muscle cramps caused on by increased blood flow (QB >300 ml/min), inter-dialytic weight gain, and ultrafiltration volume during dialysis.