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July 2013
July 2013

Cramps – How to Manage Them

For individuals with kidney disease, we can separate cramps into 2 types:

Dialysis related
Night time
If you are not on dialysis, then they will be only the night-time cramps (even if they happen during the day). What do we know about them? Actually, we don’t know very much.

We have no studies that show electrolyte imbalances (low levels of potassium or magnesium) cause them. So, eating that banana will only raise your potassium and probably not help that cramp. We also have no studies that show dehydration causes them. But we know dehydration hurts your kidneys – so we always recommend additional water (unless your kidney Doctor has limited water). Discuss your fluid amount with your kidney doctor.

We do know there is a relationship between women, prolonged standing, decreased activity and increased risk for cramps to happen at night. So, the following steps may help your cramps (they sure won’t cause any problems):

Do not stand for long periods of time (sit down occasionally).

Try to increase your activity, bicycling has been shown to be helpful in preventing cramps (even one of those little bicycles that you can use as you sit in your regular chair).

Do a heel and leg stretch 3 times per day per leg for 30 seconds each time. You will feel it pull all the way up your leg (you can put your foot on a small step and then lower only the heel). Do this also right before bed and hold onto some furniture to support yourself.

There are a few medications that MIGHT increase cramps: statins, certain inhalers, possibly thiazide like diuretics or potassium sparing diuretics. Water pills (diuretics) have had conflicting or questionable cramp side-effects – so it may be the fluid volume that has to be “pulled” out – not the actual medication.

We used to prescribe quinine pills –but they have a dangerous heart rhythm effect – so they are not prescribed now. Vitamin C (low dose 60-100mg) and Vitamin E (low dose 60 mg or less) has also been helpful, especially if you take these pills together as a preventive. Discuss these vitamin supplementation with your kidney doctor to be sure there is no reason that you should not take these supplements.

elizabeth-evans Elizabeth Evans RMA DNP