How to Prevent Dialysis Muscle Cramps

1. Muscles twitches
2. Firm or tender muscles.
3. Pain in an area that cramps

• Placing you flat on your back with your legs slightly elevated¹
• Gently stretching the muscle¹
• Reducing the rate of fluid removal
• Administering normal saline

• Excessive weight gain between dialysis treatments: This excess fluid must be taken off at your next dialysis session, and you’ll need a higher ultrafiltration (UF) rate to achieve your dry weight (normal weight with no additional fluid). If your body can’t handle the higher UF rate, you may cramp.
• Overly aggressive fluid removal: Cramps can also happen if too much fluid is removed during the treatment. Tell a member of your care team if you think you may have gained weight.
• Cutting dialysis sessions short or skipping treatments: Reduced time on dialysis can lead to excessive fluid gains, requiring higher UF rates, which can cause cramping.
• Too much salt (sodium): High-sodium foods in your diet can cause increased thirst and excessive fluid gains between treatments, requiring a higher UF rate.

1. Longer or more frequent treatments—If prescribed by your doctor, extending dialysis time or receiving therapy more frequently each week can lower your UF rate, helping decrease the risk of cramping.
2. Complete your dialysis sessions as prescribed—Completing your full dialysis sessions as prescribed can help manage your fluid and prevent fluid overload.²
3. Manage fluid gains between treatments—Follow your plan for daily intake of liquids to prevent fluid overload, also called hypervolemia.³
4. Manage sodium intake—Limit sodium (salt) intake to 2,000 mg or less. Too much sodium can make it harder for your kidneys to balance the sodium and water in your body. That can mean feeling thirsty, which can lead to fluid weight gain.⁴
5. Consider home dialysis—Peritoneal dialysis (PD) and home hemodialysis (HHD) are home dialysis modalities that can be prescribed by your nephrologist. Because they are administered more frequently than in-center hemodialysis, PD and HHD can help your body regulate fluid better, and may reduce the potential for cramping.^5,6

References

¹ Agar, Dr. John. Home Dialysis Central. 2014. “Heading Off the Dreaded Cramp!” https://homedialysis.org/news-and-research/blog/32-heading-off-the-dreaded-cramp.

² Fresenius Kidney Care.“The Importance of Removing Excess Fluid.” Accessed September 9, 2021. https://www.freseniuskidneycare.com/thrive-central/removing-excess-fluid.

³Fresenius Kidney Care.;Hypervolemia and Signs of Fluid Overload. Available at: https://www.freseniuskidneycare.com/thrive-central/hypervolemia. Accessed 9 September 2021.

⁴ Fresenius Kidney Care. “Choosing Low Sodium Foods.” Accessed September 9, 2021. https://www.freseniuskidneycare.com/thrive-central/low-sodium-foods.

⁵ Fresenius Kidney Care. “Home Hemodialysis: What to Expect.” Accessed September 9, 2021. https://www.freseniuskidneycare.com/treatment/home-hemodialysis/what-to-expect.

⁶ Fresenius Kidney Care. “Benefits of Home Dialysis.” Accessed September 9, 2021. https://www.freseniuskidneycare.com/treatment/benefits-of-home-dialysis.